Difference between revisions of "Abusive head trauma"

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This article covers '''abusive head trauma''' in infants.  It commonly goes by the name '''shaken baby syndrome''', abbreviated '''SBS''.  An common alternate term is '''shaken-impact syndrome'''; this is advocated by some as it is uncertain with shaking alone is sufficient to cause the classic pattern of injuries.
This article covers '''abusive head trauma''' in infants.  It commonly goes by the name '''shaken baby syndrome''', abbreviated '''SBS'''.  An common alternate term is '''shaken-impact syndrome'''; this is advocated by some as it is uncertain with shaking alone is sufficient to cause the classic pattern of injuries.


==Defining features==
==Defining features==

Revision as of 15:00, 25 March 2012

This article covers abusive head trauma in infants. It commonly goes by the name shaken baby syndrome, abbreviated SBS. An common alternate term is shaken-impact syndrome; this is advocated by some as it is uncertain with shaking alone is sufficient to cause the classic pattern of injuries.

Defining features

Clinical triad

Classically described as:[1]

  1. Retinal haemorrhage.
  2. Subdural hemorrhage (SDH).
  3. Acute encephalopathy.
    • Some say brain swelling.[2]

Pathologic triad

  1. Subdural hemorrhage (SDH).
    • May be "thin film" type.
  2. Retinal hemorrhage/nerve sheath hemorrhage.[3]
  3. Hypoxic encephalopathy.

Other features

Subcortical slit-like haemorrhages:[4][5]

  • Classically frontal lobe.
  • Shear force.
  • Associated with shaken baby.

Related

Sinovenous thrombosis

  • Usually not associated with SDH.

DDx:

  • Coagulopathy, as may be seen in sepsis.
  • Trauma.

Blood work of shock

  • Glucose - high (IV fluids).
  • WBC - high.
  • LFTs - high (ischemia).
  • INR - high (dilutional).
  • Hb - low (dilutional).

Neonatal giant cell hepatitis

See also

References

  1. Oehmichen M, Schleiss D, Pedal I, Saternus KS, Gerling I, Meissner C (September 2008). "Shaken baby syndrome: re-examination of diffuse axonal injury as cause of death". Acta Neuropathol. 116 (3): 317–29. doi:10.1007/s00401-008-0356-4. PMID 18365221.
  2. David Ramsay. 9 September 2010.
  3. PMID 18936952.
  4. URL: http://books.google.com/books?id=0tZIcDDe6bAC&pg=PA481&lpg=PA481&dq=slit+white+matter+hemorrhage&source=bl&ots=1v-PVo2cmI&sig=HCnZBVYvyst8vC-ZcXL396pTrIk&hl=en&ei=oh2JTMy-NsSqlAf78qyBDg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBEQ6AEwADgK#v=onepage&q=slit%20white%20matter%20hemorrhage&f=false. Accessed on: 9 September 2010.
  5. David Ramsay. 9 September 2010.
  6. Guddat, SS.; Ehrlich, E.; Martin, H.; Tsokos, M. (Sep 2011). "Fatal spontaneous subdural bleeding due to neonatal giant cell hepatitis: a rare differential diagnosis of shaken baby syndrome.". Forensic Sci Med Pathol 7 (3): 294-7. doi:10.1007/s12024-011-9227-8. PMID 21331818.