On the Theory and Practice of Shaking Infants

Caffey, John

doi:10.1001/archpedi.1972.02110140011001

Cited by 510 publications

(59 citation statements)

References 15 publications

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“…The majority of guardians modify their version of the events upon being interviewed again after the evidence of the severityof the injuries is made clear, as previously noted [19]. The age range of these patients and the preponderance of males among them are other data that have been previously observed as well [12,19,20,21]. It may be postulated that many parents treat male children more roughly than female ones.…”

Section: Discussionmentioning

confidence: 69%

Subdural Haematomas and Physical Abuse in the First Two Years of Life

Trenchs¹,

Curcoy²,

Navarro³

et al. 2007

Pediatr Neurosurg

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Objective: To analyze our institution’s work-up for patients with a diagnosis of subdural haematoma (SDH) in order to determine how many of them are secondary to child abuse, as well as to examine their final functional outcome. Methods: Retrospective review of children under 2 years of age diagnosed as having SDH between 1995 and 2005. Results: A total of 35 cases were identified. Fifteen patients that had underlying conditions that predispose them to bleed were excluded. Among the remaining 20 patients, seizures and head trauma were the main causes for consultation. All patients had a coagulation study and a head computed tomography carried out, 11 of these had a magnetic resonance imaging and 1 had a post-mortem examination. Bilateral SDHs in different stages of evolution was the most common pattern of intracranial haemorrhage. Fourteen infants had a skeletal survey, 4 had a bone scintigraphy and 19 had an ophthalmoscopic examination. Fractures were diagnosed in 7 patients and retinal haemorrhages in 11. The final diagnoses were: 10 shaken baby syndromes, 4 idiopathic SDH, 3 strokes, 2 coagulopathies and 1 accidental head injury. Upon follow-up, 1 patient had died and 9 had sustained permanent disabilities. Conclusions: Cases of infantile SDH are usually thoroughly investigated. In spite of this, sometimes it is not possible to determine the SDH aetiology. Nonetheless, shaken baby syndrome remains the most frequent cause of SDH in infants, and it carries a poor prognosis.

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Section: Discussionmentioning

confidence: 69%

Subdural Haematomas and Physical Abuse in the First Two Years of Life

Trenchs¹,

Curcoy²,

Navarro³

et al. 2007

Pediatr Neurosurg

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“…The long-term morbidity from cerebral injury associated with shaken baby [5]or shaking impact [6]syndrome is striking. The majority of studies of shaken baby syndrome or inflicted TBI are retrospective reviews of clinic or hospital records of children identified as sustaining injuries secondary to physical abuse.…”

Section: Introductionmentioning

confidence: 99%

Inflicted Traumatic Brain Injury: Relationship of Developmental Outcome to Severity of Injury

et al. 1999

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Inflicted traumatic brain injury (TBI) is a frequent consequence of physical child abuse in infants and children. Twenty-eight children who were 2–42 months of age when hospitalized for moderate to severe TBI were enrolled in a prospective, longitudinal study of neurobehavioral outcome following acquired brain injury. Relative to a comparison group, the children with inflicted TBI had significant deficits in cognitive, motor and behavioral domains when assessed with the Bayley Scales of Infant Development-II 1 and 3 months after the injury. Nearly half of the injured children showed persisting deficits in attention/arousal, emotional regulation and motor coordination. Greater injury severity, as indicated by lower coma scale scores, longer periods of unconsciousness and the presence of edema/cerebral infarctions was associated with poorer outcomes in all domains.

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“…22 In 1972 while addressing the issue of prevention Caffey wrote 41 : "Hark ye, good parents, to my words true and plain, Box 1: Key principles in emergency management of the unconscious infant when the cause is unknown…”

Section: Outcome and Preventionmentioning

confidence: 99%

Shaken baby syndrome

Blumenthal

2002

Postgraduate Medical Journal

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Shaken baby syndrome is the most common cause of death or serious neurological injury resulting from child abuse. It is specific to infancy, when children have unique anatomic features. Subdural and retinal haemorrhages are markers of shaking injury. An American radiologist, John Caffey, coined the name whiplash shaken infant syndrome in 1974. It was, however, a British neurosurgeon, Guthkelch who first described shaking as the cause of subdural haemorrhage in infants. Impact was later thought to play a major part in the causation of brain damage. Recently improved neuropathology and imaging techniques have established the cause of brain injury as hypoxic ischaemic encephalopathy. Diffusion weighted magnetic resonance imaging is the most sensitive and specific method of confirming a shaking injury. Families of children with subdural haemorrhages should be thoroughly investigated by social welfare agencies.

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On the Theory and Practice of Shaking Infants

Cited by 510 publications

References 15 publications

Subdural Haematomas and Physical Abuse in the First Two Years of Life

Subdural Haematomas and Physical Abuse in the First Two Years of Life

Inflicted Traumatic Brain Injury: Relationship of Developmental Outcome to Severity of Injury

Shaken baby syndrome

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