Abusive head trauma or shaken baby syndrome is a type of inflicted head trauma. This can be caused by a direct blow to the head, throwing or dropping a child or shaking the child. Take note that head trauma is the main cause of death in child abuse cases. If you want to learn more about this form of injury and how to manage it, click here.
How it occurs
Unlike with other types of head trauma, this head injury can occur due to injuries once a child has been shaken vigorously. Due to the structure of infants, they are at risk for harm from this action and most victims are children younger than 1 year old. The average age of victims is between 3-8 months, but these injuries can still occur in children up to 5 years old.
Those responsible in such cases are most often the parents or caregivers. The common triggers include stress or frustration when the child is crying. It is sad to note that the shaking might have the chosen effect. Although at first the baby cries more, he/she will stop crying as the brain is damaged.
When a baby is shaken forcefully, the head rotates about the neck violently since the neck muscles are not yet well developed and could not provide minimal support. The violent movement throws the brain back and forth inside the skull, oftentimes rupturing the nerves and blood vessels in the brain and tearing the brain tissue.
What are the effects?
It is important to note that abusive head trauma can often cause permanent damage. In worst cases, children die due to their injuries.
- Hearing loss
- Limited or full blindness
- Seizures
- Impaired intellect
- Developmental delay
- Speech and learning difficulties
- Cerebral palsy
- Severe mental retardation
- Problems with attention and memory
In mild cases, the infant can appear normal right after shaking but he/she might develop one or more symptoms. Oftentimes, the initial sign of a problem is not noticed until the child enters school and shows behavioral issues or learning difficulties.
What are the signs and symptoms?
In any case of abusive head trauma, the length and force of the shaking, number of episodes and if impact is involved can affect the severity of the injuries. In violent cases, the child can be unconscious, experiencing seizures or in a state of shock. In most cases, the child will not receive medical attention until the severe symptoms occur.
In less severe cases, a child who has been shaken can experience the following:
- Irritability
- Lethargy
- Vomiting
- Diminished appetite
- Poor swallowing or sucking
- Seizures
- Rigidity
- Altered consciousness
- Breathing difficulty
- Uneven pupil size
- Failure to focus the eyes or follow movement
- Inability to lift head
Diagnosing abusive head trauma
In most cases of abusive head trauma, they are brought in for treatment as “silent injuries”. It simply means that parents or caregivers do not provide a history that the child had abusive head trauma, thus doctors do not check for subtle or physical signs.
It is important to note that in most cases, infants who do not have severe symptoms are not taken to a doctor. The less severe symptoms such as irritability and vomiting can resolve and have other causes.