多発性の慢性硬膜下血腫を来したshaken-baby syndrome の1例

Multiple Chronic Subdural Hematoma in Shaken-Baby Syndrome

　Ⅰ．はじめに

　1946年アメリカの小児放射線医Caffey が，小児の長管骨の異常な多発性骨折と硬膜下出血の合併する6例をwhiplash shaken-baby syndromeと発表し²⁾，1962年にKempeがchild abuse による特殊な外傷をbattered child syndrome（被虐待児症候群）として報告して以来¹¹⁾ ，本邦においても数多くの報告がなされている^6,8,9)．今回われわれは，多発性の慢性硬膜下血腫を来したshaken-baby syndromeの1例を経験した．Shaken-baby syndromeに対する社会的対応および，頭蓋内血腫の臨床像について文献的考察を加え報告する．

　We described a case of shaken-baby syndrome with multiple chronic subdural hematomas. A 10-month-old male baby was admitted to our hospital because of loss of consciousness and convulsions. CT scan revealed an acute subarachnoid hemorrhage extending into the interhemispheric fissure and supracerebellar space. The patient was treated conservatively,and discharged from the hospital. Two months after ictus,a baby was admitted to our hospital with general fatigue. CT scan demonstrated multiple chronic subdural hematomas. Burr hole irrigation and drainage brought about complete disappearance of these lesions. Retrospectively,it was found that these multiple subdural hematomas were due to shaken-baby syndrome. Shaken-baby syndrome is a form of child abuse that can cause significant head injury,and subdural hematoma is the most common manifestation. It is well known that the outcome of shaken-baby syndrome is generally not good. It is important to suspect shaken-baby syndrome when a chronic subdural hematoma is seen in a baby.