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[Shaken baby syndrome. Report of a case]
Y B Fernandes1, J A Maciel Júnior, C M Guedes
1Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Departamento de Neurologia, Brasil.
Insights
Shaken baby syndrome, a form of child abuse, can be fatal. This case highlights the diagnostic challenges and tragic outcomes associated with abusive head trauma in infants.
Area of Science:
- Pediatrics
- Neurology
- Forensic Medicine
Background:
- Infantile seizures and non-accidental head trauma are critical pediatric emergencies.
- Child abuse, particularly abusive head trauma, presents diagnostic challenges in emergency settings.
Observation:
- A 50-day-old infant presented with generalized seizures, hypoactivity, and fundic hemorrhages.
- Cranial CT revealed interhemispheric hemorrhage and cerebral edema, indicative of severe head injury.
Findings:
- The infant's father admitted to shaking the baby due to excessive crying.
- Despite intensive care, the infant succumbed to the injuries, underscoring the severity of abusive head trauma.
Implications:
- This case emphasizes the importance of considering abusive head trauma in infants with unexplained neurological symptoms and hemorrhages.
- Early recognition and intervention are crucial, though diagnostic difficulties and the potential for fatal outcomes remain significant challenges.
- Understanding the social and epidemiological factors contributing to abusive head trauma is vital for prevention strategies.
Abstract:
The authors report the case of a 50-day-old baby who was brought to the Pediatric Emergency Room of the "Hospital de Clinicas da UNICAMP" with seizures. At the examination she presented without external signs of trauma, hypoactive and with generalized seizures. Numerous hemorrhages were found in the ocular fundi. CT scan showed interhemisferic hemorrhage and brain swelling. The child was admitted to the Pediatric Intensive Care Unit, kept under controlled ventilation and hydantal. Although these measures, she died three days later. Since the beginning there was suspicion of child abuse. One day after the admission the father told that he had shaken the baby because she was crying too much. The present paper discuss social and epidemiological aspects, and about the difficulties in the diagnosis of this syndrome that sometimes may be fatal, as in this case.