IS case 479: Shaken baby syndrome
Imaging Sciences URMC 2010
Publication Date: 2010-08-30
History
Patient is a 4-month-old girl presenting with apnea and lethargy,
Findings
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Diagnosis
Shaken baby syndrome
Discussion
Shaken baby syndrome is an extreme form of child abuse that is due to extreme cranial acceleration from violent shaking. Shaken baby syndrome is unlikely to be an isolated event, as there is usually prior evidence of abuse. Infants are very susceptible to shaking because their neck muscles are not strong enough to support their relatively large head, and because their brains are not completely myelinated. Subdural hemorrhage, due to disruption of bridging cortical veins, is the most common finding due to this method of abuse. Cerebral edema and subarachnoid hemorrhage are also seen, as well as retinal hemorrhages which are due to an abrupt rise in intracranial pressure. Although cerebral contusions are not as frequent, diffuse axonal injury is often demonstrated. Encephalomalacia is a typical late finding. There is a significant morbidity and mortality with this type of abuse, as 60% will either die or have severe mental retardation, spastic quadriplegia or severe motor dysfunction after initial presentation. The severely brain injured children that survive may suffer with cortical blindness or seizure disorders.
References
- American Academy of Pediatrics: Committee on Child Abuse and Neglect. Shaken baby syndrome: rotational cranial injuries-technical report. Pediatrics. 2001 Jul;108(1):206-10. PMID: 11433079
- Lee Y, Lee KS, Hwang DH, et al. MR imaging of shaken baby syndrome manifested as chronic subdural hematoma. Korean J Radiol. 2001 Jul-Sep;2(3):171-4. PMID: 11752989
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