Biomaterial Database

Multicystic encephalomalacia as an end-stage finding in abusive head trauma. 2011

S E Matlung, and R A C Bilo, and B Kubat, and R R van Rijn

Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands.

Abusive head trauma (AHT) is one of the most severe forms of physical child abuse. If a child initially survives severe AHT the neurological outcome can be poor. In recent years several children were seen who developed multicystic encephalomalacia (MCE) after documented severe AHT. A search of the Netherlands Forensic Institute database in The Hague was performed. Inclusion criteria were cases of AHT between 1999 and 2010 where the child was under the age of 1 year old at the time of trauma. Trauma mechanism and radiological information were collected. Five children, three boys and two girls (mean age 57 days, range 8-142 days) who developed cystic encephalomalacia after inflicted traumatic brain injury were included. Survival ranged from 27 to 993 days. In all cases judicial autopsy was performed. All cases came before court and in each case child abuse was considered to be proven. In two cases the perpetrator confessed, during police interrogation, to shaking of the child only. Although a known serious outcome, this is one of the few reports on MCE as a result of AHT. In all cases the diagnosis was confirmed at autopsy.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297	Male		Males
D001921	Brain	The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.	Encephalon
D002649	Child Abuse	Abuse of children in a family, institutional, or other setting. (APA, Thesaurus of Psychological Index Terms, 1994)	Abuse Experiences, Childhood,Child Neglect,Child Neglect Experiences,Child Neglect, Physical,Childhood Abuse Experiences,Childhood Neglect Experiences,Neglect Experience, Childhood,Neglect Experiences, Childhood,Physical Neglect, Childhood,Child Maltreatment,Child Mistreatment,Abuse Experience, Childhood,Abuse, Child,Child Neglect Experience,Childhood Abuse Experience,Childhood Neglect Experience,Childhood Physical Neglect,Childhood Physical Neglects,Experience, Child Neglect,Experience, Childhood Abuse,Experience, Childhood Neglect,Maltreatment, Child,Mistreatment, Child,Neglect Experience, Child,Neglect, Child,Neglect, Childhood Physical,Neglect, Physical Child,Physical Child Neglect,Physical Child Neglects
D003952	Diagnostic Imaging	Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy.	Imaging, Diagnostic,Imaging, Medical,Medical Imaging
D004678	Encephalomalacia	Softening or loss of brain tissue following CEREBRAL INFARCTION; cerebral ischemia (see BRAIN ISCHEMIA), infection, CRANIOCEREBRAL TRAUMA, or other injury. The term is often used during gross pathologic inspection to describe blurred cortical margins and decreased consistency of brain tissue following infarction. Multicystic encephalomalacia refers to the formation of multiple cystic cavities of various sizes in the cerebral cortex of neonates and infants following injury, most notably perinatal hypoxia-ischemic events. (From Davis et al., Textbook of Neuropathology, 2nd ed, p665; J Neuropathol Exp Neurol, 1995 Mar;54(2):268-75)	Cerebromalacia,Encephalomalacia, Multicystic,Multicystic Encephalomalacia,Cerebromalacias,Encephalomalacias,Encephalomalacias, Multicystic,Multicystic Encephalomalacias
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001284	Atrophy	Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes.	Atrophies