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Misshandlungsbedingte Kopfverletzungen und Schütteltrauma-Syndrom

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Kindesmisshandlung

Zusammenfassung

Etwa 1–10% aller Kindesmisshandlungen betreffen den Kopf und das Zentralnervensystem (ZNS). Als charakteristische Konstellation beim klassischen Schütteltrauma-Syndrom wird die Koinzidenz einer variablen, oft aber schweren und prognostisch ungünstigen diffusen Hirnschädigung (Enzephalopathie) mit subduralen Hämatomen und meist ausgeprägten retinalen Blutungen beschrieben. Bei einer bislang hohen Variabilität der Terminologie ist »Abusive Head Trauma« (AHT) mittlerweile der international empfohlene und anerkannte Begriff. Diese Verletzungen haben die gravierendsten Auswirkungen aller Misshandlungsformen, d. h. die höchste Morbidität und Mortalität. Nach amerikanischen Schätzungen sind 80% der Todesfälle durch ZNS-Verletzungen im Säuglingsalter auf Misshandlungen zurückzuführen. Insgesamt sind sie mit 66–75% die häufigste misshandlungsbedingte Todesursache und die häufigste Säuglingstodesursache im 2. Lebenshalbjahr. In etwa jeweils einem Drittel kommt es zu schweren, mittleren oder leichten bzw. fehlenden Folgeschäden. Das Risiko für junge männliche Säuglinge, Kinder aus belasteten sozioökonomischen Lebensumständen und Kinder alleinerziehender, junger Mütter ist erhöht. In etwa einem Drittel aller Fälle finden sich Hinweise auf vorhergehende Misshandlungen mit Schädigungen sowohl des Gehirns als auch anderer Organsysteme und vorherige Kontakte zur Jugendhilfe.

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Authors and Affiliations

  1. Klinik für Kinder- und Jugendmedizin, Klinikum Kassel GmbH, Mönchebergstr. 43, 34125, Kassel, Deutschland

    Dr. med. B. Herrmann

  2. Inst. Rechtsmedizin, Universitätsklinikum Gießen, Frankfurter Str. 58, 35392, Gießen, Deutschland

    Prof. Dr. med. Dr. jur. R. Dettmeyer

  3. Institut für Rechtsmedizin, Universität Köln Medizinische Fakultät, Melatengürtel 60-62, 50823, Köln, Deutschland

    Dr. med. S. Banaschak

  4. Kinder- und Jugendmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    Prof. Dr. med. U. Thyen

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  1. Dr. med. B. Herrmann
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  2. Prof. Dr. med. Dr. jur. R. Dettmeyer
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  3. Dr. med. S. Banaschak
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Herrmann, B., Dettmeyer, R., Banaschak, S., Thyen, U. (2016). Misshandlungsbedingte Kopfverletzungen und Schütteltrauma-Syndrom. In: Kindesmisshandlung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48844-7_3

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  • DOI: https://doi.org/10.1007/978-3-662-48844-7_3

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