[Neuropathological study of battered child syndrome: eight autopsy cases]

The term "battered-child syndrome" was coined by Kempe in 1962. The morphology of brain lesions in abused children is rarely reported in Japan. This clinicopathological entity in the central nervous system is characterized by retinal hemorrhages, subdural and subarachnoid hemorrhage. However, reports on microscopic findings of intracerebral lesion are fewer than those on macroscopic findings of scalp, skull and intracranial cavity. This study was performed on 8 cases of battered children who were autopsied. They consisted of six female and two male infants. The age ranged from one week to four years old. The causes of the injuries were shaking in four cases, throwing in three cases, dropping in two cases and strangling in one case, mostly in combination. CT scans were examined for three cases. CT scan revealed acute cerebral swelling and acute subdural hematoma with interhemispheric blood clot in three cases and multiple low density area in one case. Evacuation of the subdural hematoma and external decompression was performed in one case. The survival period from injury to death was one day in four cases, and 2, 3, 9 and 41 days in the others. In the gross anatomical findings there are many excoriations and bruises of the face and scalp in five cases, widespread subcutaneous hematoma in all cases and skull fracture in only two cases. The brain weight was exceedingly heavier than normal brain weight by age in five cases. In the macroscopic findings, there were marked cerebral swelling and cerebral herniation in all cases, traumatic subarachnoid hemorrhage in six cases, and thin widespread acute subdural hematoma with interhemispheric clot in four cases.(ABSTRACT TRUNCATED AT 250 WORDS)