Shaken Baby Syndrome (cont.)

Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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There are no accurate statistics, but experts estimate the incidence to be between 1,000 to 1,500 infants per year. According to the Centers for Disease Control and Prevention, of the almost 2,000 children who die from abuse or neglect each year, shaken baby syndrome accounts for 10%-12% of them. Most commonly, the victim of shaken baby syndrome is between 3 and 8 months old; however, it has been reported in newborns and in children up to 4 years of age. In addition, 25% of all children diagnosed with shaken baby syndrome die from their injuries.

Infants have very weak neck muscles and large and heavy heads in proportion to their bodies. In addition, because the infant brain is immature and needs room to grow, there is naturally a virtual space between the skull and brain to allow for development. Violently shaking an infant can cause the brain to move within the skull, resulting in cerebral contusions (bruising of brain tissue) and shearing (tearing) of blood vessels. Most commonly, the injuries associated with shaken baby syndrome include bleeding around the brain (subdural and subarachnoid hemorrhages), bleeding in the eyes (retinal hemorrhages), and spinal cord or neck injuries. Often infants will also have evidence of other non-accidental injuries, including unexplained bruises, rib fractures, or extremity fractures.

The injuries associated with shaken baby syndrome may not be immediately noticeable. Infants may present with nonspecific complaints, such as irritability or vomiting. These symptoms are caused by the developing increased pressure within the brain (intracranial pressure) caused by brain hemorrhages and swelling. These infants often develop additional symptoms, such as lethargy, breathing difficulties, and seizures.

Source: MedicineNet.com
http://www.medicinenet.com/shaken_baby_syndrome/article.htm