Shaken baby syndrome: a common variant of non-accidental head injury in infants.

TY - JOUR

T1 - Shaken baby syndrome: a common variant of non-accidental head injury in infants.

AU - Matschke, Jakob

AU - Herrmann, Bernd

AU - Sperhake, Jan

AU - Körber, Friederike

AU - Bajanowski, Thomas

AU - Glatzel, Markus

PY - 2009/3/1

Y1 - 2009/3/1

N2 - BACKGROUND: Recent cases of child abuse reported in the media have underlined the importance of unambiguous diagnosis and appropriate action. Failure to recognize abuse may have severe consequences. Abuse of infants often leaves few external signs of injury and therefore merits special diligence, especially in the case of non-accidental head injury, which has high morbidity and mortality. METHODS: Selective literature review including an overview over national and international recommendations. RESULTS: Shaken baby syndrome is a common manifestation of non-accidental head injury in infancy. In Germany, there are an estimated 100 to 200 cases annually. The characteristic findings are diffuse encephalopathy and subdural and retinal hemorrhage in the absence of an adequate explanation. The mortality can be as high as 30%, and up to 70% of survivors suffer long-term impairment. Assessment of suspected child abuse requires meticulous documentation in order to preserve evidence as well as radiological, ophthalmological, laboratory, and forensic investigations. CONCLUSIONS: The correct diagnosis of shaken baby syndrome requires understanding of the underlying pathophysiology. Assessment of suspected child abuse necessitates painstaking clinical examination with careful documentation of the findings. A multidisciplinary approach is indicated. Continuation, expansion, and evaluation of existing preventive measures in Germany is required.

AB - BACKGROUND: Recent cases of child abuse reported in the media have underlined the importance of unambiguous diagnosis and appropriate action. Failure to recognize abuse may have severe consequences. Abuse of infants often leaves few external signs of injury and therefore merits special diligence, especially in the case of non-accidental head injury, which has high morbidity and mortality. METHODS: Selective literature review including an overview over national and international recommendations. RESULTS: Shaken baby syndrome is a common manifestation of non-accidental head injury in infancy. In Germany, there are an estimated 100 to 200 cases annually. The characteristic findings are diffuse encephalopathy and subdural and retinal hemorrhage in the absence of an adequate explanation. The mortality can be as high as 30%, and up to 70% of survivors suffer long-term impairment. Assessment of suspected child abuse requires meticulous documentation in order to preserve evidence as well as radiological, ophthalmological, laboratory, and forensic investigations. CONCLUSIONS: The correct diagnosis of shaken baby syndrome requires understanding of the underlying pathophysiology. Assessment of suspected child abuse necessitates painstaking clinical examination with careful documentation of the findings. A multidisciplinary approach is indicated. Continuation, expansion, and evaluation of existing preventive measures in Germany is required.

KW - Child Abuse

KW - Head Injuries, Closed

KW - Humans

KW - Incidence

KW - Infant

KW - Infant, Newborn

KW - Shaken Baby Syndrome

KW - Survival Rate

KW - Terminology as Topic

U2 - 10.3238/arztebl.2009.0211

DO - 10.3238/arztebl.2009.0211

M3 - SCORING: Journal article

C2 - 19471629

VL - 106

SP - 211

EP - 217

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

IS - 13

M1 - 13

ER -