What is the pathophysiology of physical child abuse-related CNS trauma?

Updated: Apr 24, 2017
  • Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

CNS trauma is among the most serious forms of injury that is observed in the context of physical abuse. CNS trauma may result in intracranial hemorrhage, including (1) epidural hemorrhage, which is bleeding into the space between inner skull bone surface and the dura, frequently due to a direct injury to the middle meningeal artery; (2) subdural hemorrhage, which is bleeding into the space between the inner surface of the dura and arachnoid membranes, typically caused by sheering of the bridging vessels that go from the brain surface to the dura; and (3) subarachnoid hemorrhage, which is bleeding into the space between the inner surface of the arachnoid and the brain surface.

Other CNS injuries may include contusions (ie, direct injury to the brain tissue) and intraparenchymal bleeding (ie, bleeding directly into substance of the brain). These primary injuries can be obscured or complicated by anoxic brain injuries and swelling, which are frequently seen in complex head injury, whether accidental or inflicted.


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