Usporedba karakteristika kraniocerebralnih ozljeda koje su nastale fizičkim zlostavljanjem djeteta u odnosu na ozljede nastale nesretnim slučajem

master's thesis

• Title (english): Comparison of characteristics of craniocerebral injuries caused by physical abuse of a child in relation to injuries caused by an accident
• Author: Dorotea Vrbančić
• Mentor: Marija Baković (mentor)
• Committee member: Vedrana Petrovečki (predsjednik povjerenstva)
• Committee member: Davor Mayer (član povjerenstva)
• Committee member: Marija Baković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Forensic Medicine); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Forensic Medicine

Abstract

Kraniocerebralne ozljede ili zatvorene ozljede endokranija u dječjoj dobi, uz nejasne mehanizme ozljeđivanja u heteroanamnezi ili pak uz heteroanamnezu koja negira ikakvu traumu, kliničara trebaju alarmirati na moguće fizičko zlostavljanje, posebice malog djeteta. Rano prepoznavanje zlostavljanog djeteta važno je kako bi se dijete uklonilo iz nepovoljnog okružja u kojem odrasta i na taj način spriječilo njegovo teže ozljeđivanje, eventualne zaostale trajne posljedice, pa i smrt djeteta. Djeca do 4. godine života pod najvećim su rizikom za nastanak kraniocerebralnih ozljeda ako ih se fizički zlostavlja, a od posljedica istih najviše i umiru. Fizičkim zlostavljanjem (tipično tresenjem malog djeteta s ili bez direktnog udarca glavom) nastaju intraduralna (subduralna) krvarenja, difuzna aksonalna ozljeda mozga i retinalna krvarenja. Stradavanjem nesretnim slučajem, napose pri prometnim nesrećama i padovima, nastaju kraniocerebralne ozljede koje mogu varirati od blažih površinskih ozljeda glave do prijeloma lubanjskih kostiju s ekstraduralnim (epiduralnim) krvarenjem, ali i intraduralnim krvarenjem i difuznom ozljedom mozga. Zbog djelomičnog preklapanja ozljeda koje nastaju slučajnim ozljeđivanjem i fizičkim zlostavljanjem, pri obradi takvih pacijenata, osim samih ozljeda glave, važno je pažljivo razmotriti i heteroanamnestičke podatke, eventualno postojanje drugih ozljeda na tijelu, kao i podatke o eventualnom ranijem ozljeđivanju djeteta. Osim pravovremenog prepoznavanja fizičkog zlostavljanja, važno je provoditi prevenciju svih vrsta nesreća u djece, jer su one značajan uzrok morbiditeta i mortaliteta djece u svijetu.

Abstract (english)

Craniocerebral injuries or closed intracranial injuries in childhood, with unclear injury mechanisms in the medical history or with a medical history that denies any trauma, should alert the clinician to possible physical abuse, especially of a young child. Early recognition of an abused child is important in order to remove the child from an unfavorable environment in which they are growing up, and thus prevent more severe injuries, potential permanent consequences, and even death. Children up to 4 years of age are at the highest risk for craniocerebral injuries if physically abused, and they have the highest mortality rate from these injuries. Physical abuse (typically shaking a small child with or without direct head impact) causes intradural (subdural) hemorrhages, diffuse axonal brain injury and retinal hemorrhages. Accidental injuries, particularly in traffic accidents and falls, result in craniocerebral injuries that can range from minor superficial head injuries to skull fractures with extradural (epidural) hemorrhages, as well as intradural hemorrhage and diffuse brain injury. Due to the partial overlap of injuries caused by accidental injury and physical abuse, when evaluating such patients, it is important to carefully consider medical history, the potential presence of other body injuries and any history of previous injuries. In addition to the timely recognition of physical abuse, it is important to implement prevention measures for all types of accidents in children, as these are a significant cause of morbidity and mortality among children worldwide.

• Keywords: kraniocerebralne ozljede; fizičko zlostavljanje djeteta; nesretan slučaj
• Keywords (english): craniocerebral injuries; physical child abuse; accident
• Language: croatian
• URN:NBN: urn:nbn:hr:105:529013
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-27 14:58:02