Abstract
Over the past three years 15 children have been admitted to the paediatric intensive care unit (PICU) at Addenbrooke's hospital suspected of having non-accidental injuries; presentation was diverse and often mild and out of proportion to the degree of morbidity seen at discharge and follow up. When compared with a group of similar aged children admitted to the PICU with severe head injury caused by accidental impact trauma, the differences in morbidity were profound. It is suggested that these differences are explained in part by the predominant repetitive rotational forces experienced during severe shaking compared with the translocational forces that the head experiences during impact injuries. This anecdotal evidence supports the theory that shaking alone may cause severe intracranial injury. Thus campaigns should continue to increase public and doctors' awareness that shaking may be dangerous.
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Selected References
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- Alexander R., Sato Y., Smith W., Bennett T. Incidence of impact trauma with cranial injuries ascribed to shaking. Am J Dis Child. 1990 Jun;144(6):724–726. doi: 10.1001/archpedi.1990.02150300124032. [DOI] [PubMed] [Google Scholar]
- Bonnier C., Nassogne M. C., Evrard P. Outcome and prognosis of whiplash shaken infant syndrome; late consequences after a symptom-free interval. Dev Med Child Neurol. 1995 Nov;37(11):943–956. doi: 10.1111/j.1469-8749.1995.tb11949.x. [DOI] [PubMed] [Google Scholar]
- Brown J. K., Minns R. A. Non-accidental head injury, with particular reference to whiplash shaking injury and medico-legal aspects. Dev Med Child Neurol. 1993 Oct;35(10):849–869. doi: 10.1111/j.1469-8749.1993.tb11563.x. [DOI] [PubMed] [Google Scholar]
- Caffey J. On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation. Am J Dis Child. 1972 Aug;124(2):161–169. doi: 10.1001/archpedi.1972.02110140011001. [DOI] [PubMed] [Google Scholar]
- Carty H., Ratcliffe J. The shaken infant syndrome. BMJ. 1995 Feb 11;310(6976):344–345. doi: 10.1136/bmj.310.6976.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Duhaime A. C., Alario A. J., Lewander W. J., Schut L., Sutton L. N., Seidl T. S., Nudelman S., Budenz D., Hertle R., Tsiaras W. Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age. Pediatrics. 1992 Aug;90(2 Pt 1):179–185. [PubMed] [Google Scholar]
- Duhaime A. C., Gennarelli T. A., Thibault L. E., Bruce D. A., Margulies S. S., Wiser R. The shaken baby syndrome. A clinical, pathological, and biomechanical study. J Neurosurg. 1987 Mar;66(3):409–415. doi: 10.3171/jns.1987.66.3.0409. [DOI] [PubMed] [Google Scholar]
- Frank Y., Zimmerman R., Leeds N. M. Neurological manifestations in abused children who have been shaken. Dev Med Child Neurol. 1985 Jun;27(3):312–316. doi: 10.1111/j.1469-8749.1985.tb04541.x. [DOI] [PubMed] [Google Scholar]
- Hadley M. N., Sonntag V. K., Rekate H. L., Murphy A. The infant whiplash-shake injury syndrome: a clinical and pathological study. Neurosurgery. 1989 Apr;24(4):536–540. doi: 10.1227/00006123-198904000-00008. [DOI] [PubMed] [Google Scholar]
- Ludwig S., Warman M. Shaken baby syndrome: a review of 20 cases. Ann Emerg Med. 1984 Feb;13(2):104–107. doi: 10.1016/s0196-0644(84)80571-5. [DOI] [PubMed] [Google Scholar]
- Sarsfield J. K. The neurological sequelae of non-accidental injury. Dev Med Child Neurol. 1974 Dec;16(6):826–827. doi: 10.1111/j.1469-8749.1974.tb03409.x. [DOI] [PubMed] [Google Scholar]
- Sinal S. H., Ball M. R. Head trauma due to child abuse: serial computerized tomography in diagnosis and management. South Med J. 1987 Dec;80(12):1505–1512. doi: 10.1097/00007611-198712000-00006. [DOI] [PubMed] [Google Scholar]
- Wilkinson W. S., Han D. P., Rappley M. D., Owings C. L. Retinal hemorrhage predicts neurologic injury in the shaken baby syndrome. Arch Ophthalmol. 1989 Oct;107(10):1472–1474. doi: 10.1001/archopht.1989.01070020546037. [DOI] [PubMed] [Google Scholar]
- Zimmerman R. A., Bilaniuk L. T., Bruce D., Schut L., Uzzell B., Goldberg H. I. Interhemispheric acute subdural hematoma: a computed tomographic manifestation of child abuse by shaking. Neuroradiology. 1978;16:39–40. doi: 10.1007/BF00395197. [DOI] [PubMed] [Google Scholar]