| Abstract | Sindrom protresenog djeteta opasno je stanje do kojeg dolazi pri djetetovoj izloženosti brzoj akceleracijskoj, deceleracijskoj ili rotacijskoj sili uzrokovanoj protresanjem, s ili bez prisustva udarca, a karakteriziran je pojavom subduralnog krvarenja, retinalnih krvarenja i hipoksično-ishemične encefalopatije, pogotovo uz odsustvo dokaza o mehanizmu nastanka ozljede. Inicijalno se smatralo kako protresanje djeteta dovodi do rupture mostnih vena i bilateralnog subduralnog krvarenja te posljedičnog razvoja retinalnih krvarenja, ali novija istraživanja sve više govore u prilog hipoksično-ishemičnog mehanizma ozljede. Protresanje je obično precipitirano ljutnjom roditelja ili skrbnika zbog djetetovog nepodnošljivog i neutješnog plača. Tipična žrtva sindroma protresenog djeteta je muško dojenče uglavnom mlađe od šest mjeseci. Incidencija nije povezana s rasom, spolom, socioekonomskim statusom ili obrazovanjem, a rizični čimbenici još se istražuju. Simptomi s kojima se dijete prezentira najčešće nisu specifični, stoga je jako bitno prepoznavanje kliničkih značajki sindroma protresenog djeteta od strane zdravstvenih djelatnika. Iako se kod pregleda djeteta traga za ozljedama nanesenim udarcem ili protresanjem, zabilježeni su slučajevi smrtnih ishoda ili teških posljedica u djece koja se inicijalno nisu prezentirala vidljivim vanjskim ozljedama. Detaljna medicinska obrada, liječenje i rehabilitacija žrtava sindroma protresenog djeteta predstavljaju veliko opterećenje za zdravstveni sustav, skrbnike i društvo ako se na vrijeme ne prepoznaju. S obzirom na to da je sindrom protresenog djeteta jedan od vodećih uzroka morbiditeta i mortaliteta u dojenačkoj dobi, izuzetno je važna senzibilizacija i edukacija medicinskog osoblja i šire javnosti o navedenom problemu, kao i provođenje preventivnih edukacijskih programa. |
| Abstract (english) | Shaken Baby Syndrome is a dangerous condition in a child being exposed to rapid acceleration, deceleration or rotational force caused by shaking, with or without an additional impact, characterized by the presence of subdural hemorrhage, retinal hemorrhages and hypoxic ischemic encephalopathy, especially when there is no evidence of the mechanism of injuries. Initially, it was considered that shaking a child leads to the rupture of bridging veins and the emergence of bilateral subdural hemorrhage, as well as to the consequent development of retinal bleeding, however recent studies are favor the hypoxic ischemic mechanism of injury. Shaking is usually triggered by the anger of a parent or a guardian due to child's intolerable and inconsolable crying. A typical victim of Shaken Baby Syndrome is a male infant, usually younger than six months. Incidence is not related to race, gender, socioeconomic status or education and risk factors are still being investigated. The symptoms with which the child is presented are most often not specific, therefore, it is very important that the clinical characteristics of Shaken Baby Syndrome are recognized by the healthcare professionals. Even though traces of injuries caused by impact or shaking are searched for during examination of the child, there have been cases of death or serious consequences in children who were not initially presented with visible external injuries. Detailed medical diagnostics, treatment and rehabilitation of the victims of Shaken Baby Syndrome are a major burden to the health care system, caregivers and society if they are not recognized in time. Given that Shaken Baby Syndrome is one of the leading causes of morbidity and mortality in infants, it is extremely important to sensitize and educate medical staff and the public in general about the problem of Shaken Baby Syndrome, as well as to conduct preventive educational program. |
