Physicians have an ethical and legal mandate to identify abused children so that they may be protected from further harm and are simultaneously required to think broadly and objectively about differential diagnoses. The medical literature is replete with examples of medical diseases that mimic abuse, potentially leading to misdiagnoses and subsequent harm to children and families. This review highlights some of the common and uncommon diseases that mimic physical and sexual abuse of children. Christian provides medical-legal expert work in child abuse cases. Published January 25, Accessed January 13, 2. The effects of childhood stress on health across the lifespan. Burden and consequences of child maltreatment in high-income countries.
I have an anxiety disorder on and off. This raises my BP readings. The risk here is sudden incapacitation. Still is a disqualifier. Does vertigo disqualify me from getting a medical card?
Jul 01, · Acute Subdural Haematoma (SDH) is the collection of blood between the dural and the arachnoid layers of the meninges. It is one of the most common types of intracranial mass lesion associated with high mortality and morbidity.
Tweet Pin After spending decades hosting a show requiring people to use their brains, Jeopardy host Alex Trebek is recovering from issues with his own. He is currently taking medical leave from the long-running game show to recover from surgery he had in mid-December to remove blood clots from his brain. Back in October, Trebek took a hard fall, hitting his head. This resulted in subdural hematoma, which caused the blood clots.
He was diagnosed with the condition in mid-December, and had surgery to treat it the next day. Because episodes are taped months ahead of their airdate, the broadcast schedule should not be affected with the exception of the College Championship, which will now air in April. What is subdural hematoma? A hematoma is the swelling of clotted blood within the tissues caused by an injury to the wall of a blood vessel, which prompts blood to seep out into the surrounding area.
On some parts of the body, they are visible, like a purplish bruise or a lump. But on other parts — like the brain — there’s no physical evidence of the blood clots.
Neurologic and Mental
I Hate My Husband He Always Yells just asking my husband a simple question or anyhting and he has to yell his response or answer like a loud, obnoxious, rude, uncivilized freak! Oldest Rating Ladies, you have my sympathies its terrible your men treat you. I am a husband and never behave like that towards my wife. However, I seem to have the opposite problem – my wife doesn’t stop shouting and being abusive to me.
In the frontal aspect of the left chronic subdural hematoma a linear focus of high density is seen and this represents an area of acute subdural hematoma within the chronic subdural hematoma. Another acute subdural hematoma was noted in the left posterior fossa (not pictured).
The estimation of time since injury in cases of subdural haemorrhage has been studied only by a few investigators on the histological and radiological front. Materials and Methods The study included a total of cases of closed head injury with subdural haemorrhage. Results Statistically significant results were obtained between the HU measurements of the SDH and the post-traumatic intervals and were found to be statistically significant. A rough attempt was made to determine the effect of haematoma volume on attenuation and was found out to be statistically insignificant.
Conclusion The density of the subdural haematoma decreases with increase in the post-traumatic interval that concurs with the limited number of studies being conducted in the past. We concluded that further sorting of cases could be done according to its age with additional research and uniformity in the methodology.
The Management of Minor Closed Head Injury in Children
Community-service and law-enforcement authorities have taken a role in protecting potential victims and in prosecuting perpetrators. Most reports of abuse were submitted by educational personnel Other important advantages of the skeletal survey include a high sensitivity for most acute and healing fractures and a relatively low radiation burden. Geometric distortion and varying exposures are unacceptable limitations of this image. Use of a high-detail, high-contrast, screen-film system with good spatial resolution is mandatory.
The relationship of age to clinical and pathological findings was analyzed in adult patients operated on because of chronic subdural hematoma. A well-formed membrane on the inner and outer surface of the hematoma was used as the criterion for chronicity of the hematoma. Younger patients had.
The understanding of subdural hematoma relies on the knowledge neuroanatomical sheets covering the brain. The brain is the central repository of delicate neural tissue. This network of neurons and neuronal connective tissue is prone to injury without the protective layers starting with the scalp and the bony structures of the skull. First, there is a leather-like structure called the dura mater, derived from the neural crest, adhering to the periosteum and inward. It faces the other meningeal structure, the arachnoid mater.
It is often called the middle meningeal layer forming many villi piercing through the dura with bridging veins acting as one-way valves to drain the neural tissue lying underneath the last meningeal layer called the pia mater. In this context, the structure stretches bridging veins and renders them prone to rupture.
Brain Contusions Simply explained, a brain contusion is a bruise of the brain tissue. Just like bruises that occur on other parts of the body, a brain contusion is caused by small blood vessel leaks. Because they involve structural brain damage, contusions are more serious than concussions. Get a Free Legal Evaluation Causes of Brain Contusions Brain contusions are most often caused by an impact to the head , such as those sustained in a car accident, a fall, or a sports-related accident.
Apr 01, · Currently, the dating of subdural haemorrhage by measuring the CT number alone could lead to inaccuracies as it depends on measurement technique, object composition, and beam energy.
The Amanda Truth Project: Bleeding between the brain and skull subdural hematoma 2. Bleeding behind the eye bilateral retinal hemorrhaging 3. Ayub Ommaya ‘s article “Whiplash. John Caffey from the United States picked up Guthkelch’s observations and continued on with his own studies. She died soon after. In the past decade, that consensus has begun to come undone. A small but growing number of doctors warn that there can be alternate explanations — infections or bleeding disorders, for example — for the triad of symptoms associated with shaken-baby syndrome.
Across the country, the group of lawyers that has succeeded in exonerating hundreds of people based on DNA evidence is now mounting 20 to 25 appeals of shaken-baby convictions. Ommaya took more than 50 rhesus monkeys and strapped each one into a chair mounted on wheels, leaving their heads unsupported. He placed the chair on a foot-long track, and an air-powered piston sent the monkeys zooming into a wall.
Hearing loss or hearing ringing tinnitus Blurred Vision Causes[ edit ] Subdural hematomas are most often caused by head injury , when rapidly changing velocities within the skull may stretch and tear small bridging veins. Subdural hematomas due to head injury are described as traumatic. Much more common than epidural hemorrhages , subdural hemorrhages generally result from shearing injuries due to various rotational or linear forces.
A subdural hematoma is a collection of blood between the covering of the brain (dura) and the surface of the brain. Causes A subdural hematoma is most often the result of a severe head injury.
Facts about the brain: The brain contains around billion neurons. We have all our neurons when we are babies, but they aren’t yet connected as in an adult. Further, the brain is not fully myelinated until age years. This probably explains most developmental milestones, including those of Piaget. The brain has a great deal to do with our learning, thinking, mood, speech and behavior.
See the end of this unit if you are philosophically inclined; many scientists are, and there are many different ideas. This leaves a lot of room for unrecognized syndromes and explanations for personality and interest variables. Skinner was a good person who was right about many things, but he tended to overlook the fact that we’re born different. In retrospect, few people believed him, even at the time History of Psychology 3: Brain disease is common.
Alzheimer’s disease, once considered either “rare” or “a normal part of growing old” and therefore ignored, is finally being recognized as a major public health problem. There are about 17, cases of primary malignant brain tumors in the US yearly; the majority prove fatal. There are about , people in the U.
Diagnostic Imaging in Child Abuse
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Dating of a subdural hematoma by visual inspection is unreliable, but histologically, using the Munro and Merritt chart, greater accuracy is possible. Although the Munro and Merritt dating concept was done from limited adult data, it is the most comprehensive study to date.
Aborted fetal tissue Alternate Explanations The myth that children don’t die from short falls is incorrect on its face. We know from published medical data that perfectly healthy children die of short falls ft. Furthermore, the myth that children don’t die of short falls, assumes that those children do not possess any intervening factors that would make them more fragile to a head injury. As a metaphor, it would generally be assumed, and supported by medical literature, that children do not die of paper cuts or minor external head wounds.
This would however be defied by cases involving hemophiliacs. One would be in great error to assume that a child was abused simply because it was disparate from the norm, without paying careful attention to intervening factors. In SBS cases doctors generally are unable because the baby is deceased or uninterested in pursuing other explanations for the injuries, once a diagnosis of SBS has been reached. It needs to be made clear from the outset that we believe that short falls can and do kill healthy children.
However, there are also several underlying medical conditions that can lessen the degree of force necessary to cause the injuries found in “SBS” cases: Witnesses for the State will generally argue that chronic subdural hematomas do not bleed or re-bleed without force equal to or greater than that incurred in a story fall. This testimony however is not supported by the literature on re-bleeds.
Most of the literature available on chronic subdural hematomas is on hematomas in adults. However, for adults it is generally assumed that chronic subdural hematomas by their very nature evolve and can re-bleed over time.
Traumatic Brain Injury
Lumpy Like any combination of these characteristics When you push on a hematoma, it may move around under the skin, feeling uncomfortable or even painful. Though these signs and symptoms may be disconcerting, they are not usually a cause for alarm. Usually, the body will eventually reabsorb the blood that formed the hematoma without any need for treatment. Treatment for Bruising Bruises will generally heal on their own, but treatment may help a hematoma heal faster and in some cases, offer relief from any pain or discomfort.
There are many ways to treat this issue , including:
An acute subdural hematoma (SDH) is a clot of blood that develops between the surface of the brain and the dura mater, the brain’s tough outer covering, usually due to .
Abstract Introduction Microscopic study of the organization of the Subdural Haemorrhage SDH verified against the time period can help us in the determination of its age which has serious medico-legal implications. Very few studies concerning the dating of SDH are present in the literature. Aim This study was conducted for dating the early subdural haemorrhage by routine histopathological stains. Materials and Methods A prospective analytical study was conducted during July to December A total of cases 50 males and 50 females fulfilling the inclusion and exclusion criteria were included in this study.
Routine histopathological staining of the subdural haematoma was done. Results Correlation between the frequency of a given histomorphological phenomenon and the length of the Post-Traumatic Interval PTI was evidential. All the histomorphological features, when correlated with PTI groups, were found to be statistically significant, except for Polymorphonuclear Leukocytes PMN. Conclusion We concluded that routine histopathology was reliable in the dating of early subdural haemorrhages.
Medico-legal, Polymorphonuclear leuckocytes, Post-traumatic interval, Subdural haematoma Introduction Road traffic accidents take about 1. One more fact to be noticed is that deaths due to head trauma outnumber the deaths caused due to injury to any other region [ 5 ].