|
Fong, D., Lee, A.C.,
Luk, S.H., & So, K.T. (1999). The shaken baby syndrome:
Review of 10 cases. Hong Kong Medical Journal, 5, 337-341. |
| Objective |
To study
the characteristics of the shaken baby syndrome in 10 cases in Hong Kong. |
| Methods |
This was
a retrospective study at Regional Public Hospital in Hong Kong. The
patients included six boys and four girls (mean age, 0.54 years; range,
0.18-1.42 years) in whom shaken baby syndrome was diagnosed between January
1994 and June 1998. The main outcome measures involved clinical features
at presentation, radiological findings, management, and outcome. |
| Results |
All 10
patients were in a coma, with 4.8 (range, 3-10) as the mean score on the
Glasgow Coma Scale. In all cases, the history provided by the caregivers
was incompatible with the patient's presentation. Nine patients had
seizures. Retinal hemorrhages were detected in all patients, but
peripheral signs of bruising were observed in only three cases. Acute
subdural hematoma was found in eight patients. One of the remaining
two children had subarachnoid and subdural hemorrhages, whereas the other
had subarachnoid and intracerebral hemorrhages. Skeletal fractures
were detected in two patients. The suspected perpetrators included
either or both parents, child minders, and maids. The identity of
the abusers in two cases were unknown. In three of the cases, prosecution
by the police was initiated, and two of these abusers were found to be
guilty. Three children died of the abuse, while the seven survivors
had significant neurological impairments. |
| Conclusion |
Medical
practitioners should be alert of abusive head trauma in infants due to
shaken baby syndrome. Peripheral signs appear to be uncommon and
a high degree of suspicion is needed for management of abuse to be successful. |
