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嬰兒搖晃症候群(Shaken baby syndrome)－病例報告
Shaken Baby Syndrome-A Case Report
摘要
嬰兒搖晃症候群大部份發生在一歲以下之受虐兒，或因照顧者的無知而引起。因無明顯外在的症狀所以診斷不易。本篇報告一例八個月大女嬰，因抽搐及意識不佳而就醫，經電腦斷層及核磁共振檢查發現有廣泛的腦部梗塞及萎縮和硬腦膜下血腫(subdural hematoma)，眼底可見雙側多處視網膜出血；於一歲時追蹤檢查發現有新的硬腦膜下血腫，大腦明顯的萎縮與軟化(encephalomalacia)，眼底視網膜出血已消退，但雙眼視神經盤較蒼白。該幼兒另有右側輕偏癱(hemiparesis)及運動發展遲緩的現象。此症候群在台灣很少見到，希望藉向此病例之報告，讓眼科醫師能更深刻的了解其臨床表徵，以便能早期診斷。
關鍵字
無資料並列摘要
Most of the victims of shaken baby syndrome are found in child abuse or ignorance of caretaker. Diagnosis is difficult due to absence of obvious symptoms. It is most prevalent under 1-year-old, especially under 6 months of age. Because of poor expression of their symptoms, delayed diagnosis is common. Patients were always sent to hospital very late by a guilty caretaker. We presented a case who was a 8-month-old infant admitted due to convulsion and consciousness disturbance. Brain CT and MRI revealed extensive infarcts, shrinkage of brain and subdural hematoma. Fundus revealed bilateral multiple retinal hemorrhage. After 4 months follow-up, MRI revealed marked at rophy & cystic encephalomalacia of the cerebrum. Fundus revealed mildly pale disc with absorption of retinal hemorrhage. Motor function of the child showed mild hemiparesis of right extremity and retardation of the motor development.