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Battered child syndrome: cerebral ultrasound and CT findings after vigorous shaking
Insights
Repetitive whiplash-shaking in children can cause severe brain damage and atrophy. Cerebral sonography and Doppler sonography can diagnose these injuries and guide treatment.
Area of Science:
- Pediatric neurology
- Neuroradiology
Background:
- Child abuse via whiplash-shaking can result in severe cerebral damage, neurological deficits, and intellectual disability.
- Cerebral damage may occur with or without visible external head trauma.
Observation:
- Sonographic imaging of two children subjected to repetitive whiplash shaking revealed cerebral edema upon admission or within 48 hours.
- Follow-up sonography demonstrated significant brain atrophy in both cases.
Findings:
- Cerebral sonography identified cerebral edema and subsequent brain atrophy in children experiencing whiplash-shaking trauma.
- Cranial computerized tomography confirmed these sonographic findings.
- Doppler sonography effectively monitored intracranial blood flow, assessing cerebral perfusion.
Implications:
- Cerebral sonography combined with Doppler sonography is a valuable diagnostic tool for identifying abusive head trauma.
- These imaging techniques allow for therapy adjustments based on the patient's current clinical condition.
Abstract:
Child abuse by whiplash-shaking can lead to severe cerebral damage, neurological defects and mental retardation. Cerebral damage has been found with and without external evidence of head injury. We report the sonographic findings in two children after traumatization due to repetitive vigorous whiplash shaking. Cerebral sonography revealed cerebral edema at admission or within 48 hours thereafter. Follow-up studies demonstrated development of marked brain atrophy in both cases. The sonographic findings were confirmed by cranial computerized tomography. Doppler sonography was used to monitor cerebral perfusion by measuring intracranial blood flow. The clinical history of the patients demonstrates that cerebral sonography in combination with Doppler sonography not only serves as a diagnostic tool but also allows adjustment of therapy to the actual clinical status of the patient.