Skip to main content

Advertisement

Log in

Arterial dissection and stroke following child abuse: case report and review of the literature

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

Arterial dissection and stroke following trauma are seen frequently. Although similar mechanisms occur for trauma and child abuse, no reports of stroke have been observed in the literature.

Case reports

Two patients successively presented to our institution with acute onset of neurological deficit and stroke. Further evaluation disclosed child abuse as an underlying condition leading to the strokes. Child protection services were contacted immediately after admission of the patients and further measures were taken.

Conclusions

Recognition of potential cases of child abuse is crucial. Early intervention and cessation of interaction between the aggressor and the child are important measures to be taken in all situations when there is strong evidence of suggestive examination of child abuse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Altman RL, Kutscher ML, Brand DA (1998) The “shaken-baby syndrome”. N Engl J Med 339:1329–1330

    Article  Google Scholar 

  2. Aoki N, Masuzawa H (1986) Subdural hematomas in abused children: report of six cases from Japan. Neurosurgery 18:475–477

    Google Scholar 

  3. Bacon CJ, Sayer GC, Howe JW (1978) Extensive retinal haemorrhages in infancy—an innocent cause. Br Med J 1:281–292

    Google Scholar 

  4. Bird CR, McMahan JR, Giles FH, Senac MO, Apthorp JS (1987) Strangulation in child abuse: CT diagnosis. Radiology 163:373–375

    Google Scholar 

  5. Brandt T, Grond-Ginsbach C (2002) Spontaneous cervical artery dissection: from risk factors toward pathogenesis. Stroke 33:657–658

    Google Scholar 

  6. Caffey J (1974) The whiplash shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain damage and mental retardation. Pediatrics 54:396–403

    Google Scholar 

  7. Christian CW, Taylor AA, Hertle RW, Duhaime AC (1999) Retinal hemorrhages caused by accidental household trauma. J Pediatr 135:125–127

    Google Scholar 

  8. Clark BJ (2001) Retinal hemorrhages: evidence of abuse or abuse of evidence? Am J Forensic Med Pathol 22:415–416

    Article  Google Scholar 

  9. Demaerel P, Casteels I, Wilms G (2002) Cranial imaging in child abuse. Eur Radiol 12:849–857

    Article  Google Scholar 

  10. Eisenbrey AB (1979) Retinal hemorrhage in the battered child. Childs Brain 5:40–44

    Google Scholar 

  11. Feldman KW, Brewer DK, Shaw DW (1995) Evolution of the cranial computed tomography scan in child abuse. Child Abuse Negl 19:307–314

    Article  Google Scholar 

  12. Friendly DS (1971) Ocular manifestations of physical child abuse. Trans Am Acad Ophthalmol Otolaryngol 75:318–332

    Google Scholar 

  13. Fukuda I, Meguro K, Matsusita S, Shigeta O, Oohashi N, Nakata Y (1989) Traumatic disruption of bilateral vertebral arteries and internal carotid arteries: case report. J Trauma 29:263–266

    Google Scholar 

  14. Fulton DR (2000) Shaken baby syndrome. Crit Care Nurs Q 23:43–50

    Google Scholar 

  15. Fung EL, Sung RY, Nelson EA, Poon WS (2002) Unexplained subdural hematoma in young children: is it always child abuse? Pediatr Int 44:37–42

    Google Scholar 

  16. Geddes JF, Hackshaw AK, Vowles GH, Nickols CD, Whitwell HL (2001) Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain 124:1290–1298

    Article  Google Scholar 

  17. Geddes JF, Whitwell HL, Tasker RC (2003) Shaken baby syndrome. Br J Neurosurg 17:18–23

    Google Scholar 

  18. Glasier CM, Seibert JJ, Williamson SL (1987) Cerebral infarction in child abuse. Diagnosis by technetium-99 m methylene diphosphonate skeletal scintigraphy. Clin Nucl Med 12:897–898

    Google Scholar 

  19. Hughes KM, Collier B, Greene KA, Kurek S (2000) Traumatic carotid artery dissection: a significant incidental finding. Am Surg 66:1023–1027

    Google Scholar 

  20. Levine LM (2003) Pediatric ocular trauma and shaken infant syndrome. Pediatr Clin North Am 50:137–148

    Google Scholar 

  21. Malek AM, Higashida RT, Halbach VV, Dowd CF, Phatouros CC, Lempert TE, Meyers PM, Smith WS, Stoney R (2000) Patient presentation, angiographic features, and treatment of strangulation-induced bilateral dissection of the cervical internal carotid artery. Report of three cases. J Neurosurg 92:481–487

    Google Scholar 

  22. Mant AK (1972) Traumatic subarachnoid haemorrhage following blows to the neck. J Forensic Sci Soc 12:567–572

    Google Scholar 

  23. Massicotte SJ, Folberg R, Torczynski E, Gilliland MG, Luckenbach MW (1991) Vitreoretinal traction and perimacular retinal folds in the eyes of deliberately traumatized children. Ophthalmology 98:1124–1127

    Google Scholar 

  24. Milligan N, Anderson M (1980) Conjugal disharmony: a hitherto unrecognised cause of strokes. Br Med J 281:421–422

    Google Scholar 

  25. Ommaya AK, Goldsmith W, Thibault L (2002) Biomechanics and neuropathology of adult and paediatric head injury. Br J Neurosurg 16:220–242

    Article  Google Scholar 

  26. Rabl W, Ambach E, Tributsch W (1991) Protrahierte Asphyxie nach “Schutteltrauma”. Arch Kriminol 187:137–145

    Google Scholar 

  27. Schroth G, Lovblad KO, Ozdoba C, Remonda L (2002) Non-traumatic neurological emergencies: emergency neuroradiological interventions. Eur Radiol 12:1648–1662

    Article  Google Scholar 

  28. Starling SP, Holden JR (2000) Perpetrators of abusive head trauma: a comparison of two geographic populations. South Med J 93:463–465

    Google Scholar 

  29. Thyen U, Tegtmeyer FK (1991) Das Schutteltrauma des Sauglings—eine besondere Form der Kindesmisshandlung. Monatsschr Kinderheilkd 139:292–296

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Celso Agner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Agner, C., Weig, S.G. Arterial dissection and stroke following child abuse: case report and review of the literature. Childs Nerv Syst 21, 416–420 (2005). https://doi.org/10.1007/s00381-004-1056-6

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-004-1056-6

Keywords

Navigation