Original articleDiffusion-weighted magnetic resonance imaging in shaken baby syndrome☆
Section snippets
Patients
: We retrospectively reviewed the medical records of all infants and children younger than 2 years of age with confirmed or suspected SBS admitted to Children’s Healthcare of Atlanta at Egleston Hospital between 1998 and 2000. Medical records were obtained from the Department of Neurosurgery and from the Department of Pediatric Ophthalmology registry data banks and were cross referenced with the records of the Child Protection Program and neuroradiology referral records to identify suspected
Results
A total of 26 infants and children were included. There were 14 boys and 12 girls with a mean age of 7 months (range, 6 weeks to 24 months). Among these 26 children, 18 had confirmed SBS, and 8 had suspected SBS. All patients had acute subdural hematoma as revealed by CT scanning. Skeletal survey demonstrated long bones or rib fractures in ten cases (38.5%). Retinal hemorrhages were found in 18 patients (69%) (unilateral in 3, bilateral in 15). One case had associated vitreous hemorrhage. All
Discussion
The diagnosis of SBS remains extremely challenging. Although recent successful murder prosecutions have increased public and professional awareness of SBS,27 the syndrome is still missed by physicians.28 Conversely, it is also sometimes overdiagnosed, and some children with subdural hematomas from other causes are erroneously suspected of having SBS and their parents or caregivers falsely accused of assault.27 The consequences of such an error may be grievous.
Injuries to the head pose special
References (38)
- et al.
Shaken baby syndrome
Ophthalmology
(2000) - et al.
Cerebral complications of nonaccidental head injury in childhood
Pediatr Neurol
(1998) - et al.
Diffusion-weighted magnetic resonance imagingtheory and potential applications to child neurology
Semin Pediatr
(1999) - et al.
Excitatory amino acid concentrations in ventricular cerebrospinal fluid after severe traumatic brain injury in infants and childrenThe role of child abuse
J Pediatr
(2001) Childhood injuries in the United States
Am J Dis Child
(1990)- et al.
Nonaccidental head injury in infants—The ‘shaken-baby syndrome’
N Engl J Med
(1998) - et al.
The shaken baby syndrome. A clinical, pathological, and biomechanical study
J Neurosurg
(1987) - et al.
Head injury in very young childrenMechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age
Pediatrics
(1992) - et al.
Long-term outcome in infants with the shaking-impact syndrome
Pediatr Neurosurg
(1996) A 12-year ophthalmologic experience with the shaken baby syndrome at a regional children’s hospital
Tr Am Ophthalmol Soc
(1999)
Nonaccidental head injury in infants‘The shaken baby syndrome revisited.’
Pediatrics Ann
Neuroimaging, physical, and developmental findings after inflicted and noninflicted traumatic brain injury in young children
Pediatrics
Inflicted traumatic brain injuryRelationship of developmental outcome to severity of injury
Pediatr Neurosurg
Prognostic indicators for vision and mortality in shaken baby syndrome
Arch Ophthalmol
Role of apnea in nonaccidental head injury
Pediatr Neurosurg
Reversal sign on CTEffect of anoxic/ischemic cerebral injury in children
Am J Neuroradiol
Cerebrovascular response in infants and young children following severe traumatic brain injuryA preliminary report
Pediatr Neurosurg
Neuropathology of inflicted head injury in children. I. Pattern of brain damage
Brain
Neuropathology of inflicted head injury in children. II. Microscopic brain injury in infants
Brain
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This study was supported in part by a departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, New York, and by core grant P30-EY06360 (Department of Ophthalmology) from the National Institutes of Health, Bethesda, Maryland. Dr. Newman and Dr. Lambert are recipients of the Research to Prevent Blindness Lew R. Wasserman Merit Award.