Diagnósticos

A child who's been forcefully shaken may 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 his or her 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 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. It can show brain bruising, bleeding and signs of decreased oxygen. Because 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.

Tratamientos

Emergency treatment for a child who has been shaken may include breathing support and surgery to stop bleeding in the brain.

Oct. 28, 2017
References
  1. Mian M, et al. Shaken baby syndrome: A review. Fetal and Pediatric Pathology, 2015;34:169.
  2. Dias MS, et al. Association of a postnatal parent education program for abusive head trauma with subsequent pediatric abusive head trauma hospitalization rates. JAMA Pediatrics. 2017;171:223.
  3. NINDS shaken baby syndrome information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Shaken-Baby-Syndrome-Information-Page. Accessed Sept. 8, 2017.
  4. Shaken baby syndrome. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Shaken%20Baby%20Syndrome.aspx. Accessed Sept. 8, 2017.
  5. Narang SK, et al. Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. Journal of Pediatrics. 2016;177:273.
  6. Christian C, et al. Child abuse: Epidemiology, mechanisms, and types of abusive head trauma in infants and children. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2017.
  7. Nickels KC (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2017.
  8. Christian CW, et al. The evaluation of suspected child physical abuse. Pediatrics. 2015;135:e1337.
  9. Paul AR, et al. Non-accidental trauma in pediatric patients: A review of epidemiology, pathophysiology, diagnosis and treatment. Translational Pediatrics. 2014;3:195.

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