Shaken baby syndrome

Diagnosis

A child who's been forcefully shaken will need to be examined by many different medical specialists, as well as an expert in child abuse.

The doctor will examine the child and ask questions about the child's medical history. Various tests may be needed to detect injuries, including:

• Skeletal survey. Several X-rays of the bones — possibly including the arms, hands, legs, feet, spine, ribs and skull — may be used to determine whether fractures are accidental or purposeful. Such testing can also help find previous fractures.
• Eye exam. An eye exam can reveal bleeding in the eye and other eye injuries.
• Blood tests. Some metabolic and genetic disorders, as well as bleeding and clotting disorders, can cause symptoms similar to shaken baby syndrome. Blood tests can help rule out some of these conditions.
• Magnetic resonance imaging (MRI). MRI uses a powerful magnetic field and radio waves to create detailed images of a child's brain and spine. It can show brain bruising, bleeding and signs of decreased oxygen. Because an MRI is difficult to perform on a child who's unstable, it's usually done two to three days after the injury.
• Computerized tomography (CT) scan. A CT scan uses X-ray images to provide cross-sectional images of the body. A CT scan of the brain can help detect injuries that need urgent treatment. A CT scan of the abdomen may also be done to determine if there are additional injuries.

Depending on the extent of the injuries, the baby may need to be monitored in a pediatric intensive care unit.

Treatment

Emergency treatment for a child who has been shaken may include breathing support and surgery to stop bleeding in the brain. Some children may require medications to reduce brain swelling and prevent seizures.