Shaken Baby Syndrome

Shaken baby syndrome (SBS) is also called Abusive head trauma (AHT). This means an injury to a child's brain as a result of child abuse. It is never okay to shake or throw a young child. It may not leave any obvious sign of injury, but it can cause serious long-term problems or even death. This often occurs when a baby won't stop crying and a caregiver loses control of his or her emotions. Parents can help prevent this problem by learning healthy ways to relieve stress and anger. It destroys a child's brain cells and prevents his or her brain from getting enough oxygen.

Anatomic features make infants especially prone to neurologic injury from excessive shaking or trauma. Infants have a large head compared with their body size, and the cervical paraspinal muscles are weak. The infant brain has a higher water content than that of the adult brain, and it is incompletely myelinated. The subarachnoid spaces are also larger in infants than in adults. When the infant is shaken, movement of the immature brain in relation to the skull and the poor muscle tone in the neck cause the bridging vessels to tear, resulting in the classic finding of a subdural hematoma. Retinal hemorrhages are produced when venous congestion causes rupture of the retinal vasculature. Therefore, shaken baby syndrome is defined by subdural hemorrhage and retinal hemorrhage. One additional feature is occult fractures, particularly of ribs and long bone metaphyses.

For more than 30 years, the "triad" of injuries that define SBS have been retinal hemorrhages, bleeding around the brain, and brain swelling that have been caused by shaking a baby.