Shaken Baby Syndrome

What is Shaken Baby Syndrome?

Shaken baby syndrome is a sign which indicates that the brain tissues are not getting enough oxygen supply due to damage of the brain tissues. Damage of the brain tissue is the resultant from serious brain injury. Alternatively this syndrome is also termed as abusive head trauma. Lack of oxygen supply to brain tissue often leads to permanent brain damage.

This syndrome arises up till 5 years of a child’s age. Usually this happens, when baby falls down and his/her head gets direct injury or when head forcefully collides against any hard object. It may also happen when child is abused. After any accident, if baby’s head gets affected then the incidence may result the baby to get shaken. In such instance, immediate medical assistance is required; otherwise it can be fatal for baby’s health.

Shaken Baby Syndrome Causes

Abuse of baby; is mostly the reason of shaken baby syndrome. Under the age of five, the anatomical development of the body is immature which also include brain structure. The spongy brains and flexible neck easily become twisted due to any forceful heating or injury to the brain.

The injury of the spine, eyes and even bone fracture may be a reason of shaken baby syndrome. The unbearable pain make baby irritable. The continuous shaking of the brain can cause brain collision against the skull wall due to repeated or forceful hitting.

During the shaken of infant’s body, the internal structure of the brain including nerve and blood vessels may get damaged which also hampers the oxygen supply to the brain tissues.

Babies under 2 years of age are mainly affected by shaken baby syndrome. Due to the immature anatomical structures which include oversized skull, flexible or weak neck muscles are unable to hold the brain tightly. Fragile internal brain structure is the reason behind the great impact of their body after forceful fall down and in such case the head is directly affected.

Shaken Baby Syndrome Symptoms & Signs

For shaken baby syndrome the following are the symptoms:

• Baby’s body is forcefully shaken
• Baby fell to asleep
• Difficult to stay awake
• Respiratory distress
• Uncontrollable crying
• Become fussy, irritable, or lethargic
• Heart rate become slow
• Hearing problem
• Unable to eat or drink
• Pale skin
• Vomiting
• Epileptic attack
• Paralysis
• Vision loss
• Coma

Other than these cases, baby sometime may not be having tremor, the sign is indicated by X- ray or eye examination. The usual signs that doctors find with this syndrome are rib fracture or clotting of blood inside or around the eye.

Shaken Baby Syndrome Diagnosis

The sign and symptomatic judgment is tough for shaken baby syndrome, as they are not very particular, so for diagnosis the physical examination and other lab diagnosis are important.

Physical examinations that are included are:

• Brain inflammation or encephalopathy
• Brain haemorrhage, particularly at the subdural region.
• Bleeding at the back chamber of the eye or at the retinal region, it also termed as retinal haemorrhage.

Apart from these physical examinations the following lab tests also important to conduct for confirmation:

• To get a cross-sectional brain image, doctors usually performs CT scan
• Another approach to get the internal brain structure image is through MRI, in which high resonance magnetic fields are taking the images of the baby’s brain.
• X-ray is conducted for detection of internal bone fracture including vertebral column, ribs and skull. The fractures of these delicate bones are also causes shaken baby syndrome.
• Eye checking, especially for bleeding inside the eye which helps to detect the eye injury.
• As the shaken baby syndrome is associated with other causes which include meningitis, for confirming this cebro-spinal fluid testing is important.
• Blood test is also conducted to confirm other infection that could be a possible cause of shaken baby syndrome.

Shaken Baby Syndrome Management

• To treat the patient and to restrict the further complications, most of the time patient needs emergency care in ICU, where ventilation support or oxygen therapy helps the patient to overcome the oxygen deficiency.
• For reduction of internal brain inflammation, medication is provided through parenteral route, which provide immediate action.
• In case of high body temperature, antipyretic drugs are prescribed to control the body temperature.
• To stop the internal brain hemorrhage, doctors may also conduct brain surgery.
• To calm down the patient, doctors may give them sedatives.

Following are the preventive measures:

• Don’t over excite the baby, when they cry too much. It is always appreciable to calm them down by attracting their attention to some funny thing, tempting them to which they love the most, motivate them and divert their mind.
• Try to get some professional caregiver, so that baby should not be abused.
• Parental education is also helpful to prevent such incidences.
• Try to mingle the child with others close to them like siblings or grandparents.
• Avoid over excitement when baby becomes fussy.

References:

1. http://www.webmd.com/parenting/baby/tc/shaken-baby-syndrome-topic-overview?page=2
2. http://www.mayoclinic.org/diseases-conditions/shaken-baby-syndrome/basics/treatment/con-20034461
3. http://kidshealth.org/parent/medical/brain/shaken.html#
4. http://www.healthline.com/health/shaken-baby-syndrome#Diagnosis3
5. http://www.babycenter.com/0_abusive-head-trauma-shaken-baby-syndrome_1501729.bc