Abstract：
In infantile abusive head injury (AHT), subdural haemorrhage (SDH) is commonly held to result from traumatic damage to bridging veins traversing from the surface of the brain to the dura and dural venous sinuses. However, there are limited published radiological or autopsy demonstrations of ruptured bridging veins and several authors also assert that bridging veins are too large to rupture due to the forces associated with AHT. There have been several studies on the size, locations and numbers of adult bridging veins and there is one small study of infant bridging veins. However, there are no microscopic studies of infant bridging veins and only a select few ultrastructural investigations of adult bridging veins. Hitherto, it has been assumed that bridging veins from infants and younger children will display the same anatomical characteristics as those in adulthood. At 19 neonatal, infant and young child post-mortem examinations, we macroscopically examined and sampled bridging veins for microscopy. We compared the histology of those samples with bridging veins from an older child and two adults. We demonstrate that adult bridging veins are usually surrounded by supportive meningeal tissue that appears to be lacking or minimally present around the bridging veins of younger children. Neonatal, infant and young children\'s veins had a free \'bridging\' section. Neonatal and infant bridging veins had smaller diameter ranges and thinner walls (some only 5-7 µm) than those seen in older children and adults. Bridging vein walls contained both fine strands of elastic fibers and a more pronounced elastic lamina. The presence of an elastic lamina occurred more frequently in the older age groups These anatomical differences between the veins of adults and young children may help to explain apparent increased vulnerability of neonatal/infant bridging veins to the forces associated with a shaking-type traumatic event.
摘要：
在婴儿虐待性颅脑损伤（AHT）中，硬膜下出血（SDH）通常是由于从大脑表面到硬脑膜和硬脑膜静脉窦的桥接静脉的创伤性损伤所致。然而,关于桥静脉破裂的放射学或尸检证明有限，几位作者还断言，由于与AHT相关的力量，桥静脉太大而不能破裂。已经有一些关于尺寸的研究，成人桥静脉的位置和数量，还有一项关于婴儿桥静脉的小型研究。然而,没有对婴儿桥静脉的微观研究，只有对成人桥静脉的超微结构研究。到目前为止，据推测，婴儿和年幼儿童的桥接静脉将显示出与成年期相同的解剖学特征。新生儿19岁时，婴儿和幼儿验尸，我们宏观检查和采样桥静脉进行显微镜检查。我们将这些样本的组织学与年龄较大的孩子和两个成年人的桥接静脉进行了比较。我们证明，成人桥接静脉通常被支持性脑膜组织包围，这些脑膜组织似乎缺乏或最少存在于年幼儿童的桥接静脉周围。新生儿,婴幼儿的静脉有一个免费的“桥接”部分。与年龄较大的儿童和成人相比，新生儿和婴儿桥静脉的直径范围较小，壁较薄（仅5-7µm）。桥接的静脉壁包含细的弹性纤维束和更明显的弹性薄层。在年龄较大的人群中，弹性层的存在更为频繁。成人和幼儿静脉之间的解剖学差异可能有助于解释新生儿/婴儿桥接静脉对与震动型创伤事件相关的力量的脆弱性明显增加。
