Document Detail


Hypernatremia and subdural hematoma in the pediatric age group: is there a causal relationship?
MedLine Citation:
PMID:  10582352     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Several researchers in the 1950's proposed that hypernatremia causes water to leave brain cells, shrinking the brain, thus tearing the bridging veins and resulting in subdural hematomas. Although the old literature suggests mechanisms linking the two in a cause and effect relationship, there is controversy as to whether hypernatremia leads to subdural bleeding or whether the reverse is true. This issue is important for forensic pathologists who must distinguish natural disease from trauma. An etiologic link between hypernatremia and subdural hematomas was suggested recently, and was proposed originally before Kempe's 1962 paper "The Battered Child Syndrome" which widely disseminated the concepts of child physical abuse, and of subdural bleeding resulting from non-accidental injury. Our study is a multifaceted investigation of infants which includes: a literature review, retrospective chart reviews of both living and deceased hypernatremic infants, a retrospective review of infants hospitalized with subdural hematoma, and a prospective collection of head injured, hypernatremic children. We conclude that hypernatremia, if present in association with subdural hemorrhage, is most likely secondary to intracranial pathology, and that hypernatremia often develops in critically ill infants suffering from a variety of medical conditions.
Authors:
T C Handy; R Hanzlick; L B Shields; R Reichard; S Goudy
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of forensic sciences     Volume:  44     ISSN:  0022-1198     ISO Abbreviation:  J. Forensic Sci.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-16     Completed Date:  1999-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375370     Medline TA:  J Forensic Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1114-8     Citation Subset:  IM    
Affiliation:
Office of the Chief Medical Examiner of Kentucky, Department of Pathology, University of Louisville, Kentucky, USA.
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MeSH Terms
Descriptor/Qualifier:
Child Abuse / diagnosis*
Child, Preschool
Female
Forensic Medicine
Hematoma, Subdural / etiology*
Humans
Hypernatremia / complications*,  etiology
Infant
Infant, Newborn
Male
Medical Records
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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