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This is a severe form of head injury caused by violently shaking an infant or child. It usually occurs in children younger than 2 years old, but may be seen in children up to the age of 5. The violent shaking may result in severe injuries to the infant including permanent brain damage or death.

Considerations

A baby's head is large and heavy in proportion to their body. For this reason, when a baby is dropped or thrown, he will tend to land on his head. There is space between the brain and skull to allow for growth and development. The baby's neck muscles and ligaments are weak and underdeveloped. All of these factors make infants highly vulnerable to whiplash forces.

When an infant or young toddler is shaken, the soft, pliable skull is not yet strong enough to absorb much of the force. The forces are thus transmitted to the brain, which then rebounds against the skull causing bruising of the brain (cerebral contusion), swelling, pressure, and bleeding (intracerebral hemorrhage).

The large veins along the outside of the brain are also vulnerable to tear with these injuries which can lead to further bleeding, swelling, and increased pressure (subdural hematoma). This can easily cause permanent, severe brain damage or death.

Shaking an infant or small child may also cause injuries to the neck and spine. Eye damage is very common and may result in loss of vision (retinal hemorrhage).

Causes

Shaken baby syndrome is almost always caused by non-accidental trauma (child abuse). It is caused by an angry parent or caregiver shaking a baby to punish or quiet them. Many times they do not intend to harm the baby.

In rare instances, this injury may be caused accidentally by actions such as tossing the baby in the air or jogging with a baby in a backpack. It does not result from gentle bouncing or play.

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