흔들린 아이 증후군 5례

Five Cases of Shaken Baby Syndrome

  • 조옥연 (한림대학교 의과대학 소아과학교실) ;
  • 허권회 (한림대학교 의과대학 소아과학교실) ;
  • 조도준 (한림대학교 의과대학 소아과학교실) ;
  • 김덕하 (한림대학교 의과대학 소아과학교실) ;
  • 민기식 (한림대학교 의과대학 소아과학교실) ;
  • 유기양 (한림대학교 의과대학 소아과학교실) ;
  • 이열 (한림대학교 의과대학 진단방사선과학교실)
  • Cho, Ok Yeon (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Huh, Kwon Hoe (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Cho, Do Jun (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Dug Ha (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Min, Ki Sik (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Yoo, Ki Yang (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Lee, Yul (Department of Radiology, College of Medicine, Hallym University)
  • 투고 : 2002.12.06
  • 심사 : 2003.02.10
  • 발행 : 2003.04.15

초록

저자들은 경련, 구토를 주소로 입원한 환아에서 만성 경막하출혈과 망막출혈을 보여 흔들린 아이 증후군으로 진단한 5례를 경험하였다. 현재까지 국내에서는 보고와 연구가 드물지만 의료인이 흔들린 아이 증후군에 대한 가능성을 염두에 두고 좀 더 적극적으로 방사선 검사나 안과 검사를 시행하면 올바른 진단과 함께 치명적인 합병증의 발생을 감소시킬 수 있다고 사료되는 바 문헌 고찰과 함께 보고하는 바이다.

Shaken baby syndrome is a serious form of child abuse, mostly involving children younger than 2 years. It results from extreme rotational cranial acceleration induced by violent shaking. The characteristic injuries include subdural hemorrhage, retinal hemorrhage, and fracture of ribs or long bones. If physicians have no recognition of, or suspicion about, shaken baby syndrome, this syndome is difficult to diagnosis because of a lack of obvious external signs and failure of the abuser to admit his or her actions. In addition to the high mortality, 60% of survivors have significant long term neurologic and developmental abnormality. The authors experienced five cases of shaken baby syndrome presented with seizures or vomiting, without external signs of trauma. All of these cases had subdural hemorrhages, and four cases had retinal hemorrahges. In our follow up, two children were found to have sequelae such as quadriplegia, monoplegia, and developmental delay. We emphasize that early recognition and prompt treament are key to overall success of case management. The incidence of shaken baby syndrome can be reduced through public awareness and education of parents not to shake a babies.

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