Medicine (MD/DO)
Emergency Medicine
Abusive Head Trauma (Shaken Baby Syndrome)

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Abusive Head Trauma (Shaken Baby Syndrome)

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Abusive Head Trauma (Shaken Baby Syndrome)

Shaking-maracas Baby
Shaken baby syndrome is a constellation of medical findings, associated with the triad of brain hemorrhage, subdural hemorrhage and retinal hemorrhage. Another sign is various bone fractures. Children should be evaluated with a CT scan and a skeletal survey. These cases should be handled sensitively, but in instances of suspected child abuse, CPS should be notified and injuries should be well documented.
Subdural Hemorrhage
Subdural Hemorrhage-hammers

Repeated shaking can lead to subdural bleeding in children. Most commonly, subdural hemorrhage is seen, but subarachnoid bleeding can also occur. Another nervous system finding in children with shaken baby syndrome is brain swelling.

Retinal Hemorrhages
Red-tin Hemorrhage-hammers

Violent or abusive shaking can lead to bleeding in the layers of the retina, which can be accompanied with papilledema.

Bruising and Fractures
Bruises and Bone Fracture

Shaken baby syndrome also involves the finding of fractures of the child's ribs or bones where they have been twisted from shaking. A skeletal survey or bone scan may show fractures in various stages of healing.

CT of Head
Cat-scanner of Head

A CT of the head is important for assessing the extent of injuries in a child with suspected shaken baby syndrome. Often, an MRI can be used, as these are better for imaging retinal bleeds.

Skeletal Survey
Skeleton Survey

A skeletal survey is a series of X-rays of all the bones in the body. This is important for detecting all of the injuries in a child with suspected shaken baby syndrome. Often, these surveys find bones in various stages of healing from repeated abuse.

Document Injuries
Documenting Injury

It is important to document all of the injuries found in the child. This is helpful in providing information to the authorities, as well as for proper management of the child's injuries as treatment continues.

Notify Child Protective Services
CPS Child Protectors

If there is a suspicion for shaken baby syndrome, child protective services should be notified immediately. A constellation of symptoms is highly indicative of child abuse, however, it should be noted that many of these symptoms can occur from non-abusive pathologies, such as gestational trauma, vitamin C deficiency or seizure disorders.


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