Shaken Baby Syndrome (SBS)

Last updated 20.09.12

 

Features

-  Ratational acceleration of head

-  Must be violent to cause injury

 

 

-  30% die

-  30% permanent disability

-  Learning difficulty, seizure, hydrocephalus, CP, visual disorders

-  Often misdiagnosed & underdisgnosed

-  Boys > girls, typically < 6 months

-  90% abusers male

 

Associated S/S

-  Retinal haemorrhages

-  Seen up to 48hrs before intracranial lesions detected

-  80% patients

 

 

-  Fracture

-  Multiple long bone fractures

-  Skull fractures esp crossing sutures

-  Subdural Haematoma

-  Bulging/tense fontanelle

-  Increasing head size

-  Dilated pupils

-  Altered respirations

-  Soft tissue injuries

-  Irritibility, FTT, lethargy, vomiting, seizure

-  Cover story

-  May change

-  50% abusers eventually admit

 

 Retinal Haem

 

Ix

-  X-rays: fracture

-  Bone Scan: fracture

-  Fundoscopy: retinal haemorrhages

-  Head CT/MRI: Subdural haematoma, fracture

 

Mx

-  Supportive

-  DOCS (mandarotry reporting)

-  Sx if subdura haematoma

-  Opthalomolgy review

 

 

References