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Forensische Aspekte bildgebender Verfahren bei Schütteltrauma-Syndrom

Methodik, Befunde, Differenzialdiagnosen

Forensic aspects of imaging procedures in shaken baby syndrome

Methodology, findings, differential diagnoses

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Zusammenfassung

Für die klinische Diagnose des Schütteltrauma-Syndroms („shaken baby syndrome“, SBS) bedarf es eines interdisziplinären Ansatzes. Radiologische Untersuchungen spielen dabei eine große Rolle, sowohl für die Klinik als auch für die rechtsmedizinische Begutachtung. Bildgebende Verfahren von Zentralnervensystem (ZNS) und Skelettsystem stehen im Vordergrund. Die vorliegende Übersichtsarbeit stellt die aktuellen Richtlinien vor und beleuchtet das breite Spektrum an Befunden, die im Rahmen radiologischer Untersuchungen von SBS-Fällen vorgefunden werden können. Auch neuere Entwicklungen werden berücksichtigt. Abschließend werden die häufig diskutierten atraumatischen Differenzialdiagnosen dargestellt und deren forensische Implikationen erörtert.

Abstract

The clinical diagnosis of shaken baby syndrome (SBS) requires an interdisciplinary approach. Radiological investigations play a significant role in both the clinical and medicolegal assessment. The imaging investigations of the central nervous system (CNS) and the skeletal system are paramount. The present review article introduces the current guidelines and sheds some light on the wide spectrum of findings that can be found during radiological investigations of SBS cases. Recent developments are also taken into consideration. Finally, atraumatic differential diagnoses, which are frequently debated among experts are presented and their forensic implications are discussed.

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Abbreviations

AHT:

„Abusive head trauma“

a.p.:

Anterior-posterior

BESS:

„Benign enlargement of the subarachnoid spaces“

CML:

„Classic metaphyseal lesion“

CPR:

„Cardiopulmonary resuscitation“

cSDH:

Chronisches Subduralhämatom

CT:

Computertomographie

DAI:

„Diffuse axonal injury“

DTI:

„Diffusion tensor imaging“

DWI:

„Diffusion weighted imaging“

FKDS:

Farbkodierte Duplexsonographie

FLAIR:

„Fluid-attenuated inversion recovery“

GA1:

Glutarazidurie Typ I

MRT:

Magnetresonanztomographie

PR:

Projektionsradiographie

SAR:

Subarachnoidalräume

SBS:

„Shaken baby syndrome“ (Schütteltrauma-Syndrom)

SDC:

„Subdural collection“ (subdurale Flüssigkeitsansammlung)

SDE:

Subdurale Effusion

SDEm:

Subdurales Empyem

SDH:

Subdurales Hämatom

SDHHy:

Subdurales Hämatohygrom

SDHy:

Subdurales Hygrom

STIR:

„Short T1 inversion recovery“

SWI:

„Susceptibility weighted imaging“

US:

Ultraschall/Sonographie

ZNS:

Zentralnervensystem

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Authors and Affiliations

  1. Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstr. 23, 48149, Münster, Deutschland

    D. Wittschieber, H. Pfeiffer & B. Karger

  2. Institut für Rechtsmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland

    D. Wittschieber

  3. Abteilung Kinderradiologie, Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Essen, Deutschland

    S. Kinner & M. L. Hahnemann

  4. Klinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    M. L. Hahnemann

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Wittschieber, D., Kinner, S., Pfeiffer, H. et al. Forensische Aspekte bildgebender Verfahren bei Schütteltrauma-Syndrom. Rechtsmedizin 28, 486–494 (2018). https://doi.org/10.1007/s00194-018-0274-2

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