Shaken Baby Syndrome (Abusive Head Trauma)

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: Roxanne Dryden-Edwards, MD
    Roxanne Dryden-Edwards, MD

    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

What are shaken baby syndrome symptoms and signs?

The symptoms and signs of shaken baby syndrome have an extremely broad range to display. This range is due to the nature of the inflicted trauma, including the frequency, duration, and whether the result of a single event or multiple events. Behavioral changes may include the following:

  1. Extreme irritability and high-pitched crying
  2. Lethargy and poor feeding
  3. Vomiting without obvious reason
  4. Loss of social engagement (smiling, cooing, etc.)
  5. Poor suck/swallow coordination
  6. Unusual breathing patterns (continuous deep pattern or rapid and shallow pattern)

Physical changes associated with shaken baby syndrome may include the following:

  1. Bruising of the body due either to the grip strength of the individual inflicting trauma or as a consequence of hitting or being hit by blunt objects (for example, wooden spoons)
  2. Head trauma: bruising, swelling, and/or laceration of the scalp, deformity of the skull (commonly a depression due to a skull fracture)
  3. Inability of the infant eyes to track or focus on an object
  4. Abnormal increase in muscle tone or evidence of an increase in pressure of the structures of the skull (for example, brain)
  5. Seizures
  6. Hemorrhages of the retina
  7. Bleeding of the surrounding or supporting structures of the brain or in the brain substance itself (most frequently diagnosed via CT or MRI studies)
  8. Bleeding and/or drainage of clear fluid (spinal fluid -- clear fluid that surrounds the brain) from the nose or ear canal

It is crucial to note that many studies have demonstrated that 20%-50% of children who sustain shaken baby syndrome have evidence of other episodes of inflicted trauma, such as intentional burns, broken bones (most commonly rib and the long bones of the arms and legs), and/or bruising not consistent with routine and age-appropriate injury.

Medically Reviewed by a Doctor on 7/6/2015

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