Shaken Baby Syndrome
Battered Child Syndrome
Eye Injuries
Hematoma, Subdural
Child Abuse
Shaken baby syndrome. (1/27)
Shaken baby syndrome is the most common cause of death or serious neurological injury resulting from child abuse. It is specific to infancy, when children have unique anatomic features. Subdural and retinal haemorrhages are markers of shaking injury. An American radiologist, John Caffey, coined the name whiplash shaken infant syndrome in 1974. It was, however, a British neurosurgeon, Guthkelch who first described shaking as the cause of subdural haemorrhage in infants. Impact was later thought to play a major part in the causation of brain damage. Recently improved neuropathology and imaging techniques have established the cause of brain injury as hypoxic ischaemic encephalopathy. Diffusion weighted magnetic resonance imaging is the most sensitive and specific method of confirming a shaking injury. Families of children with subdural haemorrhages should be thoroughly investigated by social welfare agencies. (+info)Shaken baby syndrome in Canada: clinical characteristics and outcomes of hospital cases. (2/27)
BACKGROUND: Shaken baby syndrome is an extremely serious form of abusive head trauma, the extent of which is unknown in Canada. Our objective was to describe, from a national perspective, the clinical characteristics and outcome of children admitted to hospital with shaken baby syndrome. METHODS: We performed a retrospective chart review, for the years 1988-1998, of the cases of shaken baby syndrome that were reported to the child protection teams of 11 pediatric tertiary care hospitals in Canada. Shaken baby syndrome was defined as any case reported at each institution of intracranial, intraocular or cervical spine injury resulting from a substantiated or suspected shaking, with or without impact, in children aged less than 5 years. RESULTS: The median age of subjects was 4.6 months (range 7 days to 58 months), and 56% were boys. Presenting complaints for the 364 children identified as having shaken baby syndrome were nonspecific (seizure-like episode [45%], decreased level of consciousness [43%] and respiratory difficulty [34%]), though bruising was noted on examination in 46%. A history and/or clinical evidence of previous maltreatment was noted in 220 children (60%), and 80 families (22%) had had previous involvement with child welfare authorities. As a direct result of the shaking, 69 children died (19%) and, of those who survived, 162 (55%) had ongoing neurological injury and 192 (65%) had visual impairment. Only 65 (22%) of those who survived were considered to show no signs of health or developmental impairment at the time of discharge. INTERPRETATION: Shaken baby syndrome results in an extremely high degree of mortality and morbidity. Ongoing care of these children places a substantial burden on the medical system, caregivers and society. (+info)Shaking infant trauma induced by misuse of a baby chair. (3/27)
A 2 month old infant presented with bilateral subdural haemorrhages and bilateral subhyaloid haemorrhage. The parent admitted to forceful bouncing of the child in a baby rocker. Experiments showed that violent rocking in the chair could produce extreme alternating acceleration/deceleration forces in excess of those induced by shaking alone. Such handling could not be interpreted as accidental mismanagement and the abusive nature of the process was graphically shown in video recordings of the experiment. Prosecution resulted in a conviction for cruelty, and a suspended sentence. (+info)Shaken baby syndrome. (4/27)
A 5-month-old infant with Shaken Baby Syndrome is reported. This form of physical child abuse is often overlooked. It should be suspected in infant who present with drowsiness, coma, seizures or apnea. (+info)Shaken baby syndrome manifesting as chronic subdural hematoma: importance of single photon emission computed tomography for treatment indications--case report. (5/27)
A boy with shaken baby syndrome first presented at age 3 months with acute subdural hematoma (SDH) and was treated by subdural tapping at a local hospital. Chronic SDH was identified at a rehabilitation center at age 19 months. The chronic SDH appeared to have developed within the preceding 16 months. His physical and mental development was already delayed. Magnetic resonance (MR) imaging revealed a 20-mm thick right chronic SDH with midline shift and small bilateral subdural effusions. The chronic SDH had compressed the right cerebral hemisphere. MR imaging also disclosed bilateral cerebral atrophy. 99mTc-ethylcysteinate dimer single photon emission computed tomography (SPECT) revealed decreased cerebral blood flow (CBF) in the non-hematoma hemisphere, although CBF is said to decrease on the chronic SDH side, especially if midline shift is present. Burr hole craniotomy with external drainage was performed, but the patient showed no change in CBF postoperatively, although the volume of hematoma decreased. The patient was clinically unchanged immediately after the operation. In this case, SPECT measurement of CBF was important in evaluating the pathophysiology of the delays in physical and mental growth. Atrophy of the bilateral hemispheres was the major mechanism in the decreased CBF, not the compression by chronic SDH. MR imaging and SPECT can determine the surgical indications for chronic SDH in patients with cortical atrophy. (+info)Non-accidental fatal head injury in small children--a clinico-pathological correlation. (6/27)
Non-accidental head injury leading to massive intracranial trauma has been identified as a leading cause of death in small children. In a typical case, a child usually below the age of one year is violently shaken, leading to rupture of the connecting veins between the dura mater and the brain substance with variable degrees of bleeding into the subdural space resulting in increased intracranial pressure. The accompanying venous thrombosis affecting the vessels of the brain substance leads to cerebral hypoxia and cellular death. In this study conducted throughout the year 1999, all children below the age of 3 years who were admitted to Hospital Kuala Lumpur and had died due to non-accidental injuries were included. Postmortems, including histopathological studies, were conducted to determine the most likely mechanisms of the injuries. Ten cases were identified for the whole year. In 2 cases, both below one year of age, the features presented showed evidence of violent shaking of the infants. In 6 other cases whose average age was 13 (range 4-24) months, there were evidences of direct trauma and violent shaking. In the last two cases, aged 24 and 33 months respectively, there was only evidence of direct trauma on the heads without being shaken. This study shows that death due to intracranial trauma caused by shaking with or without direct impact is the most frequent cause of mortality in abused children. Death due to direct impact between the head and another object is a less frequent occurrence. (+info)Shaken baby syndrome: an odyssey. (7/27)
Shaken baby syndrome is evaluated in the context of its historical evolution and its veracity in referring to causal injury mechanisms. A rational assessment of the injury causation and consequent pathological states associated with the syndrome is presented. It is now evident that shaken baby syndrome evolved as a result of a faulty application of scientific reasoning and a lack of appreciation of mechanisms of injury. A brief explanation of the commonly understood usage and interface of scientific methodology and reasoning as applied to clinical medicine is given. (+info)Findings in older children with abusive head injury: does shaken-child syndrome exist? (8/27)
Shaken-baby syndrome (SBS) has been hypothesized to occur after shaking by an adult during the first 2 years of life. We wondered whether it is possible to achieve rotational forces sufficient to cause SBS-like injuries in children >2 years of age. The present study describes cases of child abuse in older children who presented with the classic ophthalmologic and intracranial findings of SBS. In this case series, 4 cases of older children (2.5-7 years old; 11.8-22 kg) who died from abusive head injuries and who had diffuse retinal hemorrhages identified antemortem were selected for review. The cases were abstracted from hospital charts, records from autopsies, coroners' and district attorneys' offices, and court transcripts. In all 4 cases the history provided by the primary caregiver did not match the severity of the injuries. Three case subjects presented with patterned bruises. Multilayered retinal hemorrhages and acute subdural hematoma were observed in all 4 cases. At autopsy, diffuse axonal injury was evident in 3 of the 4 cases; all 4 cases had optic nerve sheath hemorrhages. None of the victims had skeletal fractures on radiologic examination or at autopsy. This case series demonstrates that it is possible to observe SBS-like retinal and central nervous system findings in the older and heavier child. Our findings underscore the need for providers to consider intentional shaking as a mechanism of injury in the evaluation of abusive head injury in older children. (+info)Shaken Baby Syndrome (SBS), also known as Abusive Head Trauma, is a form of inflicted injury that occurs when a baby or young child is violently shaken. This can lead to severe brain damage, blindness, hearing loss, developmental delays, seizures, and even death. The shaking causes the baby's fragile brain to move back and forth inside the skull, resulting in bruised brain tissues, bleeding in the brain, and detachment of the retinas. It's important to note that even brief periods of shaking can result in severe consequences. SBS is a form of child abuse and should be reported immediately to authorities.
Battered Child Syndrome is a medical condition in which a child has been physically abused and harmed, often over a period of time. It is also known as Non-accidental Injury (NAI) or Inflicted Traumatic Injury. The syndrome is characterized by a pattern of injuries, including bruises, fractures, burns, and internal injuries, which are not consistent with the history provided by the caregiver.
The symptoms of Battered Child Syndrome may include:
1. Unexplained or inconsistent explanations for injuries
2. Multiple injuries in various stages of healing
3. Injuries to different parts of the body, such as the ears, mouth, and genitals
4. Frequent visits to the emergency department or doctor's office for treatment of injuries
5. Delayed seeking of medical attention for serious injuries
6. Behavioral changes, such as fearfulness, regression, or aggression
7. Developmental delays or learning difficulties
8. Failure to thrive (poor growth and weight gain)
The diagnosis of Battered Child Syndrome is made by a healthcare professional based on the history, physical examination, and any diagnostic tests that may be necessary. The syndrome is a serious form of child abuse that requires immediate intervention and protection for the child. Treatment typically involves medical care for injuries, counseling and support for the child and family, and reporting the abuse to child protective services or law enforcement agencies.
Eye injuries refer to any damage or trauma caused to the eye or its surrounding structures. These injuries can vary in severity and may include:
1. Corneal abrasions: A scratch or scrape on the clear surface of the eye (cornea).
2. Chemical burns: Occurs when chemicals come into contact with the eye, causing damage to the cornea and other structures.
3. Eyelid lacerations: Cuts or tears to the eyelid.
4. Subconjunctival hemorrhage: Bleeding under the conjunctiva, the clear membrane that covers the white part of the eye.
5. Hyphema: Accumulation of blood in the anterior chamber of the eye, which is the space between the cornea and iris.
6. Orbital fractures: Breaks in the bones surrounding the eye.
7. Retinal detachment: Separation of the retina from its underlying tissue, which can lead to vision loss if not treated promptly.
8. Traumatic uveitis: Inflammation of the uvea, the middle layer of the eye, caused by trauma.
9. Optic nerve damage: Damage to the optic nerve, which transmits visual information from the eye to the brain.
Eye injuries can result from a variety of causes, including accidents, sports-related injuries, violence, and chemical exposure. It is important to seek medical attention promptly for any suspected eye injury to prevent further damage and potential vision loss.
A subdural hematoma is a type of hematoma (a collection of blood) that occurs between the dura mater, which is the outermost protective covering of the brain, and the brain itself. It is usually caused by bleeding from the veins located in this potential space, often as a result of a head injury or trauma.
Subdural hematomas can be classified as acute, subacute, or chronic based on their rate of symptom progression and the time course of their appearance on imaging studies. Acute subdural hematomas typically develop and cause symptoms rapidly, often within hours of the head injury. Subacute subdural hematomas have a more gradual onset of symptoms, which can occur over several days to a week after the trauma. Chronic subdural hematomas may take weeks to months to develop and are often seen in older adults or individuals with chronic alcohol abuse, even after minor head injuries.
Symptoms of a subdural hematoma can vary widely depending on the size and location of the hematoma, as well as the patient's age and overall health. Common symptoms include headache, altered mental status, confusion, memory loss, weakness or numbness, seizures, and in severe cases, coma or even death. Treatment typically involves surgical evacuation of the hematoma, along with management of any underlying conditions that may have contributed to its development.
Child abuse is a broad term that refers to any form of physical, emotional, or sexual mistreatment or neglect that causes harm to a child's health, development, or dignity. According to the World Health Organization (WHO), child abuse includes:
1. Physical abuse: Non-accidental injuries caused by hitting, kicking, shaking, burning, or otherwise harming a child's body.
2. Sexual abuse: Any sexual activity involving a child, such as touching or non-touching behaviors, exploitation, or exposure to pornographic material.
3. Emotional abuse: Behaviors that harm a child's emotional well-being and self-esteem, such as constant criticism, humiliation, threats, or rejection.
4. Neglect: Failure to provide for a child's basic needs, including food, clothing, shelter, medical care, education, and emotional support.
Child abuse can have serious short-term and long-term consequences for the physical, emotional, and psychological well-being of children. It is a violation of their fundamental human rights and a public health concern that requires prevention, early detection, and intervention.
A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.
For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.
It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.
A newborn infant is a baby who is within the first 28 days of life. This period is also referred to as the neonatal period. Newborns require specialized care and attention due to their immature bodily systems and increased vulnerability to various health issues. They are closely monitored for signs of well-being, growth, and development during this critical time.
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