Abstract

LOREDO-ABDALA, Arturo et al. Shaken Baby Syndrome: Clinical features and outcome of 17 cases at the Instituto Nacional de Pediatría. Acta pediatr. Méx [online]. 2015, vol.36, n.2, pp.72-80. ISSN 2395-8235.

Introduction: Shaken baby syndrome (SBS) is an extreme form of child abuse (CA); it affects the brain and the retina. Their frequency and characteristics have not been clarified in México. Objective: To describe and clarify the possible triggers, factors the caregivers clinical manifestations and evolution. Method: Seventeen patients were diagnosed with SBS at the Instituto Nacional de Pediatría from 2002 to 2010. Results: 70% were male; the mean age was 5.7 months. The background in the child that could trigger shaking were: irritability (71%), inconsolable crying (47%) and acute illness (35%); in parents, impulsivity (29%), stress (29%) and anger (18%). The usual caregivers were the mother of the child (65%), uncles (29%), both parents (24%) and grandparents (18%); but the witness of the onset of severer symptoms was the father (35%), uncles (24%), mother (18%) or both parents (12%). The clinical manifestations were seizures (76%), irritability (41%), respiratory distress (41%), cyanosis (35%) and refusal to eat (29%). At the hospital the following were observed: seizures (82%), altered consciousness (65%), need for ventilatory support (41%) and irritability (18%). The fundus examination revealed: unilateral or bilateral retinal hemorrhage (88%), bilateral vitreous hemorrhage (53%) and retinal detachment (18%). Computed tomography scan of the skull (CTSs) showed: cerebral edema (59%), subarachnoid hemorrhage (50%), subdural hematoma (29%) and skull fracture (29%) all of these conditions substantiated the diagnosis of SBS (71%) and SBS and impacted (35%): six children died (35%), every survivor had sequelae: visual impairment (59%), motor damage (53%), seizures (50%), language problems (41%) and hearing problems (18%). Conclusion: The SBS is a form of physical abuse and should be suspected in a child less than a year old that suddenly develops seizures, cardiorespiratory distress and or arrives dead at hospital.

Keywords : Child abuse; Shaken Baby Syndrome.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )