Shaken babies--some have no impact injuries. 1996

M G Gilliland, and R Folberg
Department of Pathology, East Carolina University School of Medicine, Greenville, NC, USA.

One study has questioned the validity of shaking as a mechanism of head injury in children. A prospective, postmortem study investigated 80 deaths from head trauma to identify the roles of shaking and direct impacts. Evidence of shaking was defined as two or more of the following criteria: 1) finger marks and/or rib fractures, 2) subdural and/or subarachnoid hemorrhage, or 3) a history of vigorous shaking. Shaking to the exclusion of other head trauma was defined as the presence of two or more of the above criteria together with the complete absence of scalp or skull injuries. Nine (11.3%) of the 80 study deaths qualified as exclusively shaking injuries by this definition. Thirty (37.5%) of the deaths had direct injuries as well as two of the criteria of shaking; these deaths were classified as combined shaking and blunt trauma. Forty-one (51.3%) of the deaths had impact injuries without having two of the criteria of shaking. We reviewed the extent of ocular injuries in all the cases. We found ocular hemorrhages with increased frequency in cases with two or more of the criteria of shaking compared to cases with only impact mechanism of injury. Retinal hemorrhages continue to show themselves to be a good marker of infants injured by vigorous, intentional shaking. This study likewise confirms the observations of others that most, but not all, shaken babies have impact injuries as well.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005130 Eye Hemorrhage Intraocular hemorrhage from the vessels of various tissues of the eye. Hemophthalmos,Hemorrhage, Eye,Eye Hemorrhages
D006259 Craniocerebral Trauma Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. Frontal Region Trauma,Head Injuries,Head Trauma,Occipital Region Trauma,Parietal Region Trauma,Temporal Region Trauma,Craniocerebral Injuries,Crushing Skull Injury,Forehead Trauma,Head Injuries, Multiple,Head Injury, Minor,Head Injury, Open,Head Injury, Superficial,Injuries, Craniocerebral,Injuries, Head,Multiple Head Injuries,Occipital Trauma,Open Head Injury,Superficial Head Injury,Trauma, Head,Craniocerebral Injury,Craniocerebral Traumas,Crushing Skull Injuries,Forehead Traumas,Frontal Region Traumas,Head Injuries, Minor,Head Injuries, Open,Head Injuries, Superficial,Head Injury,Head Injury, Multiple,Head Traumas,Injuries, Minor Head,Injuries, Multiple Head,Injuries, Open Head,Injuries, Superficial Head,Injury, Craniocerebral,Injury, Head,Injury, Minor Head,Injury, Multiple Head,Injury, Open Head,Injury, Superficial Head,Minor Head Injuries,Minor Head Injury,Multiple Head Injury,Occipital Region Traumas,Occipital Traumas,Open Head Injuries,Parietal Region Traumas,Region Trauma, Frontal,Region Trauma, Occipital,Region Trauma, Parietal,Region Traumas, Frontal,Region Traumas, Occipital,Region Traumas, Parietal,Skull Injuries, Crushing,Skull Injury, Crushing,Superficial Head Injuries,Temporal Region Traumas,Trauma, Craniocerebral,Trauma, Forehead,Trauma, Frontal Region,Trauma, Occipital,Trauma, Occipital Region,Trauma, Parietal Region,Trauma, Temporal Region,Traumas, Craniocerebral,Traumas, Forehead,Traumas, Frontal Region,Traumas, Head,Traumas, Occipital,Traumas, Occipital Region,Traumas, Parietal Region,Traumas, Temporal Region
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001497 Battered Child Syndrome A clinical condition resulting from repeated physical and psychological injuries inflicted on a child by the parents or caregivers. Nonaccidental Trauma in Children,Battered Child Syndromes,Child Syndrome, Battered,Child Syndromes, Battered,Syndrome, Battered Child,Syndromes, Battered Child

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