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shaken baby syndrome

 
Medical Encyclopedia:

Shaken Baby Syndrome

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Definition

Shaken baby syndrome (SBS) is a collective term for the internal head injuries a baby or young child sustains from being violently shaken.

Description

Shaken baby syndrome was first described in medical literature in 1972. Physicians earlier labeled these injuries as accidental, but as more about child abuse became known, more cases of this syndrome were properly diagnosed.

Every year, nearly 50,000 children in the United States are forcefully shaken by their caretakers. More than 60% of these children are boys. The victims are on average six to eight months old, but may be as old as five years or as young as a few days.

Men are more likely than women to shake a child; typically, these men are in their early 20s and are the baby's father or the mother's boyfriend. Women who inflict SBS are more likely to be babysitters or child care providers than the baby's mother. The shaking may occur as a response of frustration to the baby's inconsolable crying or as an action of routine abuse.

— Bethany Thivierge


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Dictionary: shaken baby syndrome
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also shaken infant syndrome
n.
A syndrome in infants in which brain injury is caused by shaking of such violence that the child's brain rebounds against the skull, resulting in bruising, swelling, and bleeding of the brain and often leading to permanent, severe brain damage or death.


Neurological Disorder:

Shaken baby syndrome

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Definition

Shaken baby syndrome is a severe form of head injury caused by the forcible shaking of a child. The force is sufficient to cause the brain to bounce against the baby's skull, causing injury or damage to the brain.

Description

Shaking an infant forcibly transfers a great deal of energy to the infant. When the shaking occurs as the infant is being held, much of the force is transferred to the neck and the head. The force can be so great that the brain can move within the skull, rebounding back and forth from one side of the skull to the other. The bashing can be very destructive to the brain, causing bruising, swelling, or bleeding. Bleeding of the brain is also called intracerebral hemorrhage. The force of shaking can also damage the neck.

As its name implies, shaken baby syndrome can often be a result of deliberate abuse. The brain damage can also be the result of an accident. The force and length of the force necessary to cause shaken baby syndrome is debatable. What is clear is that not much time is needed, since most shaking events likely tend to last only 20 seconds or less. It is the explosive violence of the shaking that exacts the damage.

Demographics

Reliable statistics on the prevalence of shaken baby syndrome do not exist. Estimates in the United States approach 50,000 cases each year. Nearly 25% of infants with shaken baby syndrome die from the brain injuries sustained. The victims of this syndrome range in age from just a few days to five years, with an average age of six to eight months. Statistics point to men as the usual perpetrators, typically young men (i.e., early 20s). Females who shake babies tend to be caregivers. As reliable statistics emerge, it would not be unexpected to find the actual number of cases greatly exceeds these crude estimates. Abuse of children is a hidden event, so many cases of abuse, including shaken baby syndrome, are not reported or are presented in some other form (such as a fall or an accident).

Causes and symptoms

The cause of the brain, neck, and spine damage that can result from shaken baby syndrome is brute force. The violent shaking of a baby by a much stronger adult conveys a tremendous amount of energy to the infant. Part of the reason for the damage is because an infant's head is much larger than the rest of the body, in relation to an older child or an adult. This, combined with neck muscles that are still developing and are incapable of adequately supporting the head, can make shaking an explosively destructive event. The amount of brain damage depends on how hard the shaking is and how long an infant is shaken. If accidental, the force and length of the head trauma similarly determines the extent of injury.

The normal tossing and light "horse play" that can occur between an adult and an infant is not sufficient to cause shaken baby syndrome.

The damage to the brain can have dire consequences that include permanent and severe brain damage or death. Other symptoms that can develop include behavioral changes, lack of energy or motivation, irritable behavior, loss of consciousness, paling of the skin color or development of a bluish tinge to the skin, vomiting, and convulsions. These symptoms are the result of the destruction of brain cells that occurs directly due to the trauma of the blow against the skull, and secondarily as a result of oxygen deprivation and swelling of the brain. The banging of the brain against the sides of the skull causes the inflammation and swelling as well as internal bleeding. Increased intracranial pressure can be damaging to the structure and function of the brain.

Additionally, because the neck and head can absorb a tremendous amount of energy due to the shaking force of the adult, bones in the neck and spine can be broken and muscles can be torn or pulled. The eyes can also be damaged by the explosive energy of shaking. Retinal damage occur in 50–80% of cases. The damage can be so severe as to permanently blind an infant.

Shaken baby syndrome is also known as abusive head trauma, shaken brain trauma, pediatric traumatic brain injury, whiplash shaken infant syndrome, and shaken impact syndrome.

Diagnosis

Diagnosis depends on the detection of a blood clot below the inner layer of the dura (a membrane that surrounds the brain), but external to the brain. The clot is also known as a subdural hematoma. Two other critical features of shaken baby syndrome that are used in diagnosis are brain swelling and hemorrhaging in the eyes.

An infant may also have external bruising on parts of the body that were used to grip him or her during shaking. Bone or rib fractures can also be apparent. However, these external features may not always be present. Diagnosis can also involve the nondestructive imaging of the brain using the techniques of computed tomography (CT), skull x ray, or magnetic resonance imaging (MRI). Typically, these procedures are done after an infant has been stabilized and survival is assured.

Treatment team

Treatment in an emergency setting typically involves nurses and emergency room physicians. A neurosurgeon is usually consulted when shaken baby syndrome is suspected. Depending on the extent of injury, neurosurgeons can become involved if surgery for brain repair is needed.

Police officers and social workers also become involved in cases of shaken baby syndrome, who work to ensure that the child is placed in a safe environment.

Treatment

Initially, treatment is provided on an emergency basis. Life-saving measures can include stopping internal bleeding in the brain and relieving pressure that can build up in the brain because of bleeding and swelling of the brain.

Recovery and rehabilitation

If the infant survives the initial injury from shaken baby syndrome, rehabilitation focuses on recovering as much function as possible. Physical and occupational therapies can offer exercises for caregivers to provide the child, as well as any supportive or positional devices required. The full effects of the brain injury sustained in infants who survive shaken baby syndrome may not become apparent until delays in developmental milestones such as sitting alone, walking, or acquiring speech are noticed.

Clinical trials

As of May 2004, there are no clinical trials on shaken baby syndrome underway or recruiting participants in the United States. However, agencies such as the National Institute of Neurological Disorders and Stroke fund studies that seek to better understand the basis of the damage. Other agencies attempt to lessen the occurrence of the syndrome through counseling, anger management, and interventions in abusive situations.

Prognosis

The prognosis for children with shaken baby syndrome is usually poor. Twenty percent of cases result in death within the first few days. If an infant survives, he or she will most often be left with intellectual and developmental disabilities such as mental retardation or cerebral palsy. Damage to the eyes can cause partial or total loss of vision. A survivor will likely require specialized care for the remainder of his or her life.

Resources

BOOKS

Lazoritz, Stephen, and Vincent J. Palusci, eds. Shaken Baby Syndrome: A Multidisciplinary Approach. Binghamton, NY: Haworth Press, 2002.

PERIODICALS

Geddes, J. F., and J. Plunkett. "The Evidence Base for Shaken Baby Syndrome." British Medical Journal (March 2004): 719–720.

Harding, B., R. A. Risdon, and H. F. Krous. "Shaken Baby Syndrome." British Medical Journal (March 2004): 720–721.

OTHER

"NINDS Shaken Baby Syndrome Information Page." National Institute of Neurological Disorders and Stroke. May 13, 2004 (May 27, 2004). http://www.ninds.nih.gov/health_and_medical/disorders/shakenbaby.htm>.

ORGANIZATIONS

National Institute for Neurological Diseases and Stroke. P.O. Box 5801, Bethesda, MD 20824. (301) 496-5751 or (800) 352-9424. http://www.ninds/nih.gov.

The National Center on Shaken Baby Syndrome. 2955 Harrison Blvd., #102, Ogden, UT 84403. (801) 627-3399 or (888) 273-0071; Fax: (801) 627-3321. dontshake@mindspring.com. http://www.dontshake.com.

National Institute of Child Health and Human Development. 31 Center Drive, Rm. 2A32 MSC 2425, Bethesda, MD 20892-2425. (301) 496-5133; Fax: (301) 496-7101. http://www.nichd.nih.gov.

The Arc of the United States. 1010 Wayne Avenue, Suite 650, Silver Spring, MD 20910. (301) 565-3842; Fax: (301) 565-3843. info@thearc.org. http://www.thearc.org.

Think First Foundation [National Injury Prevention Program]. 5550 Meadowbrook Drive, Suite 110, Rolling Meadows, IL 60008. (847) 290-8600 or (800) 844-6556; Fax: (847) 290-9005. thinkfirst@thinkfirst.org. http://www.thinkfirst.org.


Brian Douglas Hoyle, PhD


Dental Dictionary:

shaken baby syndrome

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n

A condition of whiplash-type injuries ranging from bruises on the arms and trunk to retinal hemorrhages, coma, and convulsions, as observed in infants and children who have been violently shaken. Physicians are required by law to report cases of suspected child abuse and are granted immunity from liability for filing such reports.

Children's Health Encyclopedia:

Shaken Baby Syndrome

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Home > Library > Health > Children's Health Encyclopedia

Definition

Shaken baby syndrome (SBS) is a collective term for the internal head injuries a baby or young child sustains from being violently shaken.

Description

Shaken baby syndrome was first described in medical literature in 1972. Physicians earlier labeled these injuries as accidental, but as more about child abuse became known, more cases of this syndrome were properly diagnosed.

Demographics

Every year, nearly 50,000 children in the United States are forcefully shaken by their caretakers. More than 60 percent of these children are boys. Nearly 2,000 children die every year as a result of being shaken. The victims are on average six to eight months old, but may be as old as five years or as young as a few days.

Men are more likely than women to shake a child; typically, these men are in their early 20s and are the baby's father or the mother's boyfriend. Women who inflict SBS are more likely to be babysitters or child care providers than the baby's mother. The shaking may occur as a response of frustration to the baby's inconsolable crying or as an action of routine abuse.

Causes and Symptoms

Infants and small children are especially vulnerable to SBS because their neck muscles are still too weak to adequately support their disproportionately large heads, and their young brain tissue and blood vessels are extremely fragile. When an infant is vigorously shaken by the arms, legs, shoulders, or chest, the whiplash motion repeatedly jars the baby's brain with tremendous force, causing internal damage and bleeding. While there may be no obvious external signs of injury following shaking, the child may suffer internally from brain bleeding and bruising (called subdural hemorrhage and hematoma); brain swelling and damage (called cerebral edema); mental retardation; blindness, hearing loss, paralysis, speech impairment, and learning disabilities; and death.

Physicians may have difficulty initially diagnosing SBS because there are usually few witnesses to give a reliable account of the events leading to the trauma, few if any external injuries, and, upon close examination, the physical findings may not agree with the account given. A shaken baby may present one or more signs, including vomiting; difficulty breathing, sucking, swallowing, or making sounds; seizures; and altered consciousness.

When to Call the Doctor

A physician should be called when a baby exhibits one or more of the following: vomiting; difficulty breathing, sucking, swallowing, or making sounds; seizures; and altered consciousness. An unresponsive child should never be put to bed, but must be taken to a hospital for immediate care.

Diagnosis

To diagnose SBS, physicians look for at least one of three classic conditions: bleeding at the back of one or both eyes (retinal hemorrhage), subdural hematoma, or cerebral edema. The diagnosis is confirmed by the results of either a computed tomography scan (CT scan) or magnetic resonance imaging (MRI).

Treatment

Appropriate treatment is determined by the type and severity of the trauma. Physicians may medically manage both internal and external injuries. Behavioral and educational impairments as a result of the injuries require the attention of additional specialists. Children with SBS may need physical therapy, speech therapy, vision therapy, and special education services.

Prognosis

Unfortunately, children who receive violent shaking have a poor prognosis for complete recovery. Those who do not die may experience permanent blindness, mental retardation, seizure disorders, or loss of motor control.

Prevention

Shaken baby syndrome is preventable with public education. Adults must be actively taught that shaking a child is never acceptable and can cause severe injury or death.

Parental Concerns

When the frustration from an incessantly crying baby becomes too much, caregivers should have a strategy for coping that does not harm the baby. The first step is to place the baby in a crib or playpen and leave the room in order to calm down. Counting to 10 and taking deep breaths may help. A friend or relative may be called to come over and assist. A calm adult may then resume trying to comfort the baby. A warm bottle, a dry diaper, soft music, a bath, or a ride in a swing, stroller, or car may be offered to soothe a crying child. Crying may also indicate pain or illness, such as from abdominal cramps or an earache. If the crying persists, the child should be seen by a physician.

Resources

Books

Antoon, Alia Y. and Donovan, Mary. "Brain injuries." In Nelson Textbook of Pediatrics. 17th ed. Ed. by Richard E. Behrman, et al., Philadelphia: Saunders, 2003, 330-7.

Augustyn, Marilyn, and Zuckerman, Barry. "Impact of viokence on children." In Nelson Textbook of Pediatrics. 17th ed. Ed. by Richard E. Behrman, et al., Philadelphia: Saunders, 2003, 120-1.

Lazoritz, Stephen, and Palusci, Vincent J. Shaken Baby Syndrome: A Multidisciplinary. Binghamton, NY: Haworth Press, Incorporated, 2002.

Minns, Robert, and Brown, Keith. Shaken Baby Syndrome and Other Non-Accidental Head Injuries in Children. London: MacKeith Press, 2003.

Periodicals

Carbaugh, S.F. "Family teaching toolbox. Preventing shaken baby syndrome." Advances in Neonatal Care 4, no. 2 (2004): 118-9.

Carbaugh, S.F. "Understanding shaken baby syndrome." Advances in Neonatal Care 4, no. 2 (2004): 105-14.

Evans, H.H. "The medical discovery of shaken baby syndrome and child physical abuse." Pediatric Rehabilitation 7, no. 3 (2004): 161-3.

Lin, C.L., et al. "External subdural drainage in the treatment of infantile chronic subdural hematoma." Journal of Trauma 57, no. 1 (2004): 104-7.

Sugarman, N. "Shaken Baby Syndrome: compensating the victims." Pediatric Rehabilitation 7, no. 3 (2004): 215-20.

Organizations

Brain Injury Association. 105 North Alfred Street, Alexandria, VA 22314. (800) 444-6443 or (703) 236-6000. Web site: .

International Brain Injury Association. 1150 South Washington Street, Suite 210, Alexandria, VA 22314. (703) 683-8400. Web site: www.internationalbrain.org.

Web Sites

"Please Don't Shake Me." National Center on Shaken Baby Sybdrome. Available online at .

"Shaken Baby Information Page." National Institute of Neurological Disorders and Stroke. Available online at .

"Shaken Baby Syndrome." Shaken Baby Alliance. Available online at .

"Shaken Baby Syndrome." The Arc. Available online at .

[Article by: L. Fleming Fallon, Jr., MD, DrPH]


Wikipedia:

Shaken baby syndrome

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Shaken baby syndrome
Classification and external resources
ICD-9 995.55
MedlinePlus 000004
eMedicine topic list

Shaken baby syndrome (SBS) or Battered Baby Syndrome is a form of child abuse that occurs when an abuser violently shakes an infant or small child, creating a whiplash-type motion that causes acceleration-deceleration injuries. The injury is estimated to affect between 1,200 and 1,600 children every year in the United States.[1] It is common for there to be no external evidence of trauma.[2]

The concept of SBS was initially described by Dr. John Caffey, a radiologist, in 1946 as "parent-infant stress syndrome".[3][4][5]

SBS is often fatal and can cause severe brain damage, resulting in lifelong disability. Estimated death rates (mortality) among infants with SBS range from 15 to 38%; the median is 20–25%.[2] Up to half of deaths related to child abuse are reportedly due to shaken baby syndrome.[6] Nonfatal consequences of SBS include varying degrees of visual impairment (including blindness), motor impairment (e.g. cerebral palsy) and cognitive impairments.[citation needed]

Contents

Signs and symptoms

Subdural hematoma (arrow), bleeding between the dura mater and the brain, commonly occurs in SBS.

SBS is accompanied by a variety of signs, which range from mild to severe and nonspecific to obviously head trauma related.[2] There is no single symptom that defines SBS.[7] The characteristic injuries associated with SBS include retinal hemorrhages, multiple fractures of the long bones, and subdural hematomas (bleeding in the brain).[8] These signs have evolved through the years as the accepted and recognized signs of child abuse and the shaken baby syndrome. Medical professionals strongly suspect shaking as the cause of injuries when a baby or small child presents with retinal hemorrhage, fractures, soft tissue injuries or subdural hematoma, that cannot be explained by accidental trauma or other medical conditions. About three quarters of cases involve retinal hemorrhaging.[7] Additional effects of SBS are diffuse axonal injury, oxygen deprivation and swelling of the brain,[7] which can raise intracranial pressure and damage delicate brain tissue.

Victims of SBS may display irritability, failure to thrive, alterations in eating patterns, lethargy, vomiting, seizures, bulging or tense fontanels (the soft spots on an infant's head), increased size of the head, altered breathing, and dilated pupils.[9]

Fractures of the vertebrae, long bones, and ribs may also be associated with SBS. [10][11][12] Dr. John Caffey reported in 1972 that metaphyseal avulsions (small fragments of bone had been torn off where the periosteum covering the bone and the cortical bone are tightly bound together) and "bones on both the proximal and distal sides of a single joint are effected, especially at the knee".[13][14]

Mechanism

SBS results from rotational acceleration of the head.[2] Rotational injury is especially damaging and likely to occur in shaking trauma.[15] The type of injuries caused by shaking injury are usually not caused by falls and impacts from normal play, which are mostly linear forces.[15] The type of shaking that is necessary to cause SBS is very violent and would be clearly recognizable to an observer as dangerous and potentially deadly.[2]

Prevention

Prevention is similar to the prevention of child abuse in general. New parents, babysitters, and other caregivers can be warned about the dangers of shaking infants. A child's crying and irritation are common triggers for the frustration that can lead to violence in the caregiver.[2] Some experts offer caregivers strategies to cope with their own frustrations; for example, they may be reminded that they are not always responsible when babies cry.

Diagnosis

Hydrocephalus, an accumulation of cerebrospinal fluid, can accompany SBS.[7] CT scanning is one technique used to diagnose the condition.

SBS may be misdiagnosed and underdiagnosed, and caregivers may lie or be unaware of the mechanism of injury.[2] Commonly, there are no externally visible signs of the condition,[2] and there is no established set of symptoms that indicate it.[7] Examination by an experienced ophthalmologist is often critical in diagnosing shaken baby syndrome, as particular forms of ocular bleeding are quite characteristic.[16] No alternative condition mimics all of the symptoms of SBS exactly, but those that must be ruled out include hydrocephalus, sudden infant death syndrome (SIDS), seizure disorders, and infectious or congenital diseases like meningitis and metabolic disorders.[15] CT scanning and magnetic resonance imaging are used to diagnose the condition.[2] Conditions that may accompany SBS include bone fractures, injury to the cervical spine (in the neck), hemorrhaging of the retina (in the eye), cerebral hemorrhage or atrophy, hydrocephalus, and papilledema (swelling of the optic disc).[7]

Treatment

Treatment involves monitoring of intracranial pressure (the pressure within the skull), draining of fluid from the cerebral ventricles, and, if an intracranial hematoma is present, draining of the hematoma.[7]

Prognosis

Prognosis depends on severity and can range from total recovery to severe disability to death when the injury is severe.[7] SBS kills about one third of its victims and permanently and severely disables another third.[15] Problems resulting from SBS include learning disabilities, seizure disorders, speech disability, hydrocephalus, behavioral problems, cerebral palsy, and visual disorders.[15]

Epidemiology

Small children are at particularly high risk for the abuse that causes SBS given the large difference in size between the small child and an adult.[2] SBS usually occurs in children under the age of two but may occur in those up to age five.[2] In 2001, 903,000 children suffered from SBS and an additional 1,300 died from it.[7]

Risk factors

Caregivers that are at risk for becoming abusive often have unrealistic expectations of the child and may display "role reversal", expecting the child to fulfill the needs of the caregiver.[2] Substance abuse and emotional stress, resulting for example from financial troubles, are other risk factors for aggression and impulsiveness in caregivers.[2] Both males and females can inflict SBS, but the abusers are more often male.[2] Although it had been previously speculated that SBS was an isolated event, a history of prior child abuse is a common finding in cases of SBS.[2] In an estimated 33–40% of cases, evidence of prior head injuries, such as old intracranial bleeds, is present.[2]

History

In 1946, the concept of SBS and the term "whiplash shaken baby syndrome" was introduced by Dr. John Caffey, a pediatric radiologist.[7] The term described a set of symptoms found with little or no external evidence of head trauma, including retinal hemorrhages and intracranial hemorrhages with subdural or subarachnoid bleeding or both.[2] In 1971, Guthkelch proposed that whiplash injury caused subdural hemorrhage in infants by tearing the veins in the subdural space.[2] Development of computed tomography and magnetic resonance imaging techniques in the 1970s and 1980s advanced the ability to diagnose the syndrome.[2]

Legal issues

In July 2005, the Court of Appeals in the United Kingdom heard four appeals of SBS convictions: one case was dropped, the sentence was reduced for one, and two convictions were upheld.[17] The court found that the classic triad of retinal hemorrhage, subdural hematoma, and acute encephalopathy are not 100% diagnostic of SBS and that clinical history is also important. In the Court's ruling, they upheld the clinical concept of SBS but dismissed one case and reduced another from murder to manslaughter.[17] In their words: "Whilst a strong pointer to NAHI [non-accidental head injury] on its own we do not think it possible to find that it must automatically and necessarily lead to a diagnosis of NAHI. All the circumstances, including the clinical picture, must be taken into account."[18]

The court invalidated a "unified hypothesis" proposed by Geddes and colleagues as an alternative mechanism for the subdural and retinal hemorrhage found in suspected cases of SBS.[17] The unified hypothesis proposed that the hemorrhage was not caused by shearing of subdural and retinal veins but rather by cerebral hypoxia, increased intracranial pressure, and increased pressure in the brain's blood vessels.[17] The court reported that "the unified hypothesis [could] no longer be regarded as a credible or alternative cause of the triad of injuries": subdural haemorrhage, retinal bleeding and encephalopathy due to hypoxemia (low blood oxygen) found in suspected SBS.[17]

On January 31, 2008, the Wisconsin Court of Appeals granted Audrey A. Edmonds a new trial based on "competing credible medical opinions in determining whether there is a reasonable doubt as to Edmunds's guilt." Specifically, the appeals court found that "Edmunds presented evidence that was not discovered until after her conviction, in the form of expert medical testimony, that a significant and legitimate debate in the medical community has developed in the past ten years over whether infants can be fatally injured through shaking alone, whether an infant may suffer head trauma and yet experience a significant lucid interval prior to death, and whether other causes may mimic the symptoms traditionally viewed as indicating shaken baby or shaken impact syndrome." [19]

The term non-accidental trauma has been suggested instead of "SBS".[20]

Controversies and alternative hypotheses

Vitamin C deficiency

Some authors have suggested that certain cases of suspected shaken baby syndrome may result from vitamin C deficiency.[21][22][23] This contested hypothesis is based upon a speculated marginal, near scorbutic condition or lack of essential nutrient(s) repletion and a potential elevated histamine level.[24][25][26] A review of this hypothesis in the journal Pediatrics International concluded that there was "no convincing evidence to conclude that vitamin C deficiency can be considered to be a cause of shaken baby syndrome", but recommended that further research be conducted, to thoroughly test the hypothesis.[27]

The proponents of such hypotheses often question the adequacy of nutrient tissue levels, especially vitamin C,[28][29] for those children currently or recently ill, bacterial infections, those with higher individual requirements, those suffering from environmental challenges (e.g. allergies), and perhaps transient vaccination-related stresses.[30] However, no cases of scurvy mimicking SBS or crib death have been reported, and scurvy typically occurs later in infancy, rarely causes death or intracranial bleeding, and is accompanied by other changes of the bones and skin and invariably an unusually deficient dietary history.[citation needed]

Gestational problems

Gestational problems affecting both mother and fetus, the birthing process, prematurity and nutritional deficits can accelerate skeletal and hemorrhagic pathologies that can also mimic SBS, even before birth.[31][32][33][34] These views are not widely known, utilized or explored in conventional medicine.[citation needed]

Diffuse injury

A 2001 study reported that the predominant histological abnormality in cases of inflicted head injury in the very young is diffuse hypoxic brain damage, not DAI .[35] and suggested two possible explanations: either the unmyelinated axon of the immature cerebral hemispheres is relatively resistant to traumatic damage, or in shaking-type injuries the brain is not exposed to the forces necessary to produce DAI.[36]

Force

There has been controversy regarding the amount of force required to produce the brain damage seen in shaken baby syndrome. A biomechanical experiment in 2005 demonstrated that "forceful shaking can severely injure or kill an infant, this is because the cervical spine would be severely injured and not because subdural hematomas would be caused by high head rotational accelerations... an infant head subjected to the levels of rotational velocity and acceleration called for in the SBS literature, would experience forces on the infant neck far exceeding the limits for structural failure of the cervical spine. Furthermore, shaking cervical spine injury can occur at much lower levels of head velocity and acceleration than those reported for SBS."[37] The validity of calculations performed in that study were challenged.[38][39] A detailed explanation of the calculations was provided in a "Letter To The Editors" in February 2006.[40]

The BBC has made a documentary in 3 parts that covers arguments for and against the diagnosis of SBS.[41][42][43]

See also

  • Louise Woodward case - was famously convicted of killing Matthew Eappen in 1997 by shaking him.
  • Alan Yurko - sentenced to life in prison + 10 years (1998) without parole for the murder of his son, due to shaken baby syndrome. Later released after appeal.
  • C. Alan B. Clemetson

Footnotes

  1. ^ National Center for Injury Prevention and Control (7 September 2006). "Child Maltreatment: Fact Sheet". Centers for Disease Control and Prevention (CDC). http://web.archive.org/web/20060919055338/http://www.cdc.gov/ncipc/factsheets/cmfacts.htm. Retrieved 2006-10-09.  (via archive.org, archived 19 September 2006)
  2. ^ a b c d e f g h i j k l m n o p q r s American Academy Of Pediatrics: Committee On Child Abuse And Neglect (July 2001). "Shaken baby syndrome: rotational cranial injuries-technical report" (Free full text). Pediatrics 108 (1): 206–10. doi:10.1542/peds.108.1.206. ISSN 0031-4005. PMID 11433079. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=11433079. 
  3. ^ Caffey J (August 1972). "On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation". American Journal of Diseases of Children 124 (2): 161–9. ISSN 0002-922X. PMID 4559532. 
  4. ^ David TJ (November 1999). "Shaken baby (shaken impact) syndrome: non-accidental head injury in infancy". Journal of the Royal Society of Medicine 92 (11): 556–61. ISSN 0141-0768. PMID 10703491. 
  5. ^ Hobbs CJ, Hanks HGI, Wynne JM (1999). Child abuse and neglect-a clinician's handbook (2nd ed.). Elsevier Health. p. 78. ISBN 9780443058967. http://books.google.ca/books?id=3w_j-n1tLGcC&pg=PA78&lpg=PA78&dq=%22parent-infant+stress+syndrome%22+1946&source=bl&ots=FpKoDLg5yD&sig=9XgajaqbBc5Tc4oixQsiikSWGA0&hl=en&ei=KXkgS_a8O8aVtgeytuGhCg&sa=X&oi=book_result&ct=result&resnum=6&ved=0CBcQ6AEwBQ. 
  6. ^ Montelenone JA, Brodeur AE. (1994). Child Maltreatment: A Clinical Guide and Reference. St Louis: GW Medical Publishing. [page needed]
  7. ^ a b c d e f g h i j Mraz MA (2009). "The physical manifestations of shaken baby syndrome". Journal of Forensic Nursing 5 (1): 26–30. doi:10.1111/j.1939-3938.2009.01027.x. ISSN 1556-3693. PMID 19222686. 
  8. ^ "NINDS Shaken Baby Syndrome Information Page". National Institute of Neurological Disorders and Stroke. 2007-02-14. http://www.ninds.nih.gov/disorders/shakenbaby/shakenbaby.htm. Retrieved 2008-06-23. 
  9. ^ Types of brain injury: Shaken baby syndrome. Brain Injury Association of America. Retrieved on September 24, 2007.
  10. ^ Caffey J (1946). "Multiple fractures in the long bones of infants suffering from chronic subdural hematoma.". ARJ 56: 163–173. 
  11. ^ Kempe C, Silverman F, Steele B, Droegemuller W, Silver H (July 1962). "The Battered-Child Syndrome". JAMA 1: 105–112. http://jama.ama-sn.org/cgi/content/abstract/181/1/17. 
  12. ^ Clemetson CA (Spring 2006). "Caffey Revisited: A Commentary on the Origin of "Shaken Baby Syndrome."" (PDF). J Am Phys Surg 11 (1): 20–1. http://www.jpands.org/vol11no1/clemetson.pdf. 
  13. ^ Caffey J (August 1972). "On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation". American Journal of Diseases of Children 124 (2): 161–9. ISSN 0002-922X. PMID 4559532. 
  14. ^ Clemetson CAB (2004). "Was it "shaken baby" or a variant of Barlow's disease?" (PDF). J Am Phys Surg" 9: 78–80. http://www.jpands.org/vol9no3/clemetson.pdf. 
  15. ^ a b c d e Oral R (August 2003). "Intentional head trauma in infants: Shaken baby syndrome" (Archived). Virtual Children's Hospital. Archived from the original on 2005-02-14. http://web.archive.org/web/20050214084615/http://www.vh.org/pediatric/provider/pediatrics/shakenimpactsyndrome/. Retrieved 2006-10-09. 
  16. ^ "Shaken Baby Syndrome Resources". American Academy of Ophthalmology. http://www.aao.org/education/library/statements/shaken_baby.cfm#ocular. 
  17. ^ a b c d e De Leeuw M, Jacobs W (2007). "Shaken baby syndrome: The classical clinical triad is still valid in recent court rulings". Critical Care 11 (Supplement 2): 416. doi:10.1186/cc5576. http://ccforum.com/content/11/S2/P416. 
  18. ^ "Shaken baby convictions overturned". Special Reports (Guardian Unlimited). Thursday July 21, 2005. http://www.guardian.co.uk/child/story/0,,1533200,00.html. Retrieved 2006-10-15. 
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Further reading

External links

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Neurotrauma (S00-S09, T09.3-4, 800-805, 850-854)
Traumatic brain injury
Spinal cord injury
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