Shaken baby syndrome

Diagnosis

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

The healthcare professionals 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 may be used to determine whether fractures are accidental or intentional. X-rays may be taken of the arms, hands, legs, feet, spine, ribs and skull. Such testing also can 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 conditions, as well as bleeding and clotting conditions, can cause symptoms similar to those of shaken baby syndrome. Blood tests can help rule out some of these conditions.
• MRI scan. 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 2 to 3 days after the injury.
• CT scan. A CT scan uses X-ray images to provide cross-sectional images of the body. A scan of the brain can help detect injuries that need urgent treatment. A scan of the abdomen also may be done to determine if there are other 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 medicines to reduce brain swelling and prevent seizures.