両眼硝子体手術を行ったshaken baby syndromeの1例

A case of shaken baby syndrome treated by bilateral vitreous surgery

　生後6か月の男児に四肢硬直が突発し，画像診断で右硬膜下血腫が発見され，血腫除去が行われた。全身に外傷や骨折はなく，両親の態度にも不審がなかったので，shaken baby syndrome（揺さぶられっ子症候群）が疑われた。6日後の眼科診察で両眼に網膜と硝子体の出血が発見された。自然消退の傾向がなく，8週後に両眼に硝子体手術と水晶体切除術を行った。1年後の現在まで経過は良好である。乳幼児の眼内出血では，虐待がなく，あやしたつもりで本症候群が起こりうることを示す症例である。

　A 6-month-old male infant developed an acute rigidity of extremities. Computerized tomography showed subdural hematoma. There was no sign of child abuse including trauma,bone fracture,or behavior of parents. We therefore suspected shaken baby syndrome. Ophthalmological examinations 6 days later led to the detection of retinal and vitreal hemorrhage in both eyes. There was no tendency to spontaneous recovery. Both eyes received vitrectomy and lensectomy 8 weeks later. The postoperative course has been fine until one year later. This case illustrates that intraocular hemorrhage in an infant may result from well-intended dandling.