Shaken baby syndromeの2症例

Two cases with shaken baby syndrome

　Shaken baby syndromeの2症例を経験した。第1例は生後2か月の男児で，過呼吸と痙攣発作で受診し，くも膜下出血と診断された。溢血斑が両側の頬と腋下にあり，両眼に刷毛状の網膜出血があった。第2例は生後4か月の男児で，全身の筋弛緩で受診し，くも膜下出血と診断された。眼底に黄斑前出血があった。頭蓋内減圧手術を3回行ったが，発症105日後に死亡した。Shaken baby syn—dromeは重篤な中枢神経障害から死亡することがあり，一般に予後不良である。本症例群は，虐待がなく，あやすつもりでも起こることがあり，眼科的所見が診断の鍵になり得る。

We observed two cases of shaken baby syndrome. The first was a 2-month-old male infant with hyperpnea and convulsions as chief manifestations. He was diagnosed with subarachnoid hemorrhage. Hemor-rhagic patches were present in both cheeks and axillae. Funduscopy showed flame-shaped retinal hemor-rhages in both eyes. The second was a 4-month-old male infant with sudden atony of systemic muscles. He was diagnosed with subarachnoid hemorrhage. Funduscopy showed premacular hemorrhage. He died 105 days later in spite of venticulo-peritoneal shunt formation repeated thrice. These cases illustrate that infants of shaken baby syndrome may be fatal due to severe involvement of the central nervous system. Shaken baby syndrome may also be induced accidentally in the absence of intentional child abuse. Ophthalmological find-ings may serve as a key in its diagnosis.