網膜および網膜前出血が診断の決め手となった揺さぶられっ子症候群の2例

Retinal and preretinal hemorrhage led to the diagnosis in two cases of shaken baby syndrome

要約　目的：網膜出血と網膜前出血が診断の決め手になった揺さぶられっ子症候群（shaken baby syndrome：以下，SBS）の2症例の報告。症例：症例は10か月の男児と8か月の女児で，1例は転倒後の意識障害，ほかの1例は転倒後の嘔吐と痙攣があった。それぞれ急性硬膜下出血とクモ膜下出血が疑われ，入院後に眼科を受診した。2症例とも外傷や骨折はなく，硬膜下血腫があり，両眼後極部を中心に網膜出血と網膜前出血が多発していた。これらの所見からSBSと診断した。両症例とも1か月後には網膜出血と網膜前出血はかなり消退し退院した。結論：乳児の硬膜下血腫では，SBSの可能性を考え，速やかに眼底を検査すべきである。

Abstract.　Purpose：To report two infants who showed retinal and preretinal hemorrhage that led to the diagnosis of shaken baby syndrome. Cases：One was a male infant aged 10 months and the other was a female infant aged 8 months. One became unconscious after falling and the other showed convulsion and vomiting after falling. They were diagnosed with acute subdural hematoma and subarachnoid hemorrhage respectively. They showed no signs of trauma or bone fracture. Funduscopy showed multiple retinal and preretinal hemorrhage in the posterior fundus in both eyes. These findings led to the diagnosis of shaken baby syndrome. Fundus hemorrhages became less distinct one month later. Both cases were discharged from the hospital. Conclusion：Prompt funduscopy is recommended in infants with subdural hematoma to detect or rule out shaken baby syndrome.