How is Shaken Baby Syndrome diagnosed

The Shaken Baby Syndrome (SBS)

What is Shaken Baby Syndrome?

Shaken Baby Syndrome (SBS) is a result of some form of child abuse. Vigorous, violent shaking of the child by the upper arms or the chest causes the child's head and extremities to rotate uncontrollably. This leads to a different acceleration of the brain tissue and the skull bone. The result is a shearing of the brain against the dura mater (hard meninges) attached to the bone. This leads to a tear in the blood vessels (bridge veins) running vertically upwards between them. Retinal bleeding and diffuse brain damage are further consequences.
Diffuse brain damage caused by SBS always results in immediate neurological symptoms, even if these are variable in their severity. A shaken baby is never primarily completely normal. In addition to broken bones, children with SBS show more or less severe unspecific neurological disorders that can lead to life-threatening situations (1).

In general, the prognosis of the SBS is poor: Over two thirds of the survivors suffer severe neurological sequelae in the form of developmental disorders, severe visual, hearing and speech disorders, even permanent disabilities and death. The mortality is around 20%. (2)


Why are babies shaken?

According to Matschke et al. (2) 100 to 200 children are affected annually in Germany. A baby's shaking is mostly in response to persistent crying. Predisposing is therefore the "main crying age" in infants from 2 to 5 months. This underlines the enormous prophylactic importance. Deficits in parenting skills, low tolerance for frustration and a high propensity for violence with low impulse control as well as unfavorable social circumstances are risk factors in developing SBS.


How can an SBS be prevented?

As numerous studies from the Anglo-American region show, the SBS is avoidable. For example, Deyo et al. (3) pointed out the success of a post partum prevention program in their “Love Me… Never Shake Me” SBS Education Program.
In addition to visiting and counseling programs in families with newborns, educational talks and brochures in maternity wards and in pediatric practices would also be desirable. The pediatric nurse and the medical staff play the important role of preventive education.


Literature:

(1) Cf. Herrmann B., Sperhake J .: The Shaken Baby Syndrome - Concepts and Forensic Controversies. In: Child abuse and neglect. Journal of the DGgKV. Vol. 8 (2005), pp. 4-17.
(2) Cf. Matschke J., Herrmann B., Sperhake J., Körber F., Bajanowski T., Glatzel M .: The shaking trauma syndrome: a common form of non-accidental traumatic brain injury in infancy and early childhood . In: Deutsches Ärzteblatt International. Vol. 106 (2009), Issue 13, pp. 211-217.
http://www.aerzteblatt.de/int/article.asp?id=63967 (as of April 14, 2009)
(3) Deyo G., Skybo T., Carroll A .: Secondary analysis of the "Love Me ... Never Shake Me" SBS education program. In: Child Abuse & Neglect. Vol. 32 (2008), No. 11, pp. 1017-1025.