SHAKEN BABY SYNDROME – 10 YEARS EXPERIENCE IN A PAEDIATRIC INTENSIVE CARE SERVICE

Authors

  • Lara Lourenço Pediatric Intensive Care Department, CH São João
  • Marta Silva Pediatric Intensive Care Department, CH São João
  • Lurdes Lisboa Pediatric Intensive Care Department, CH São João
  • Teresa Cunha da Mota Pediatric Intensive Care Department, CH São João
  • Augusto Ribeiro Pediatric Intensive Care Department, CH São João

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v22.i2.10751

Keywords:

Retinal haemorrhages, shaken baby syndrome, subdural haematomas

Abstract

Introduction: Shaken baby syndrome is one of the causes of non-accidental injury most difficult to diagnose.

Objectives: To characterize the patients hospitalized in the intensive care unit with shaken baby syndrome.

Material and Methods: Retrospective study of patients admitted at the Paediatric Intensive Care Unit with shaken baby syndrome from 1 January 1999 to 31 December 2009.

Results: There were eight children with shaken baby syndrome. The mean age was 4.1 months and five patients were male. One patient had a history of trauma. The most frequent cause of admission were epileptic seizures with cardiorespiratory/ respiratory arrest (50%). Bilateral retinal haemorrhages were present in six patients (75%). The CT scan showed subdural haematomas in all patients. Seven patients (87.5%) required mechanical ventilation, and five (62.5%) required inotropic support. The mean length of hospitalization was 5.25 days (1 -11 days). One patient died. Three patients showed no sequelae. There was a transient hemiparesis in one patient. Three patients presented epilepsy and deficits in visual acuity or hearing and in one case there was loss of prior acquisitions with a moderate to severe retardation of psychomotor development.

Conclusion: In our study Shaken Baby Syndrome resulted in high morbidity with long-term sequelae in five patients (62,5%), consistent with data published in other series. The mortality rate was lower than in previous studies (12.5%). The presence of traumatic history was mentioned only in one case and, although all of them presented subdural haematomas, 25% of cases had no retinal haemorrhages. The clinical presentation was very severe and in most cases a high degree of suspicion is necessary in the diagnosis.

References

Matschke J, Herrmann B, Sperhake J, Körber F, Bajanowski T, Glatzel M. Shaken Baby Syndrome – a common variant of non -accidental head injury in infants. Dtsch Arztebl Int 2009; 106: 211 -17.

Forbes B. Abusive head trauma in infants and young children: anatomy and pathogenesis of retinal hemorrhages. In: UpTo-Date, Paysse, E (Ed), UpToDate, Waltham, MA, 2009.

Togioka BM, Arnold MA, Bathurst MA, Ziegfeld SM, Nabaweesi R, Colombani PM, et al. Retinal Hemorrhages and Shaken Baby Syndrome: an evidence -based review. J Emerg Med 2009; 37:98 -106.

Christian C, Endom E. Evaluation and diagnosis of abusive head injury in infants and children. In: UpToDate, Wiley, J (Ed), UpToDate, Waltham, MA, 2010

Christian C, Greenbaum V. Epidemiology, mechanisms and types of abusive head injury in infants and children. Acedido em: 2009. Disponível em: UpToDate.

Squier W. Shaken baby syndrome: the quest for evidence. Dev Med Child Neurol 2008; 50:10 -4.

Published

2017-01-31

How to Cite

Lourenço, L., Silva, M., Lisboa, L., da Mota, T. C., & Ribeiro, A. (2017). SHAKEN BABY SYNDROME – 10 YEARS EXPERIENCE IN A PAEDIATRIC INTENSIVE CARE SERVICE. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 22(2), 72–74. https://doi.org/10.25753/BirthGrowthMJ.v22.i2.10751

Issue

Section

Original Articles

Most read articles by the same author(s)