Shaken baby syndrome, is a non-accidental traumatic brain injury (TBI), generally diagnosed in children 3 years old and younger. As the name implies, it often occurs as the result of a baby being shaken by an adult caregiver out of frustration or anger. Babies' brains are delicate, and shaking can result in a severe head injury. Shaken baby syndrome is suspected when a child’s head injuries are inconsistent with the explanation of the injury as given by an adult. An abusive head injury can be caused by one parent, both parents, or caregiver. In less than 14% of cases, the adult is unknown to the family.
Signs and symptoms of Shaken Baby Syndrome are wide-ranging. Essentially, the physical exam, lab tests, and medical imaging conflict with the medical history given by the adult or adults bringing the child in to the hospital. Examples include repetitive injuries that produce outward symptoms over time to sudden trauma. In addition to brain injuries, clinicians also look to other parts of the body for signs of past abuse (broken bones, bruises that are inconsistent with the capability of a baby.)
Tests do not exist to prove intentional or unintentional injuries. However, certain injuries make an unintentional traumatic brain injury unlikely. In babies, retinal and optic nerve sheath injuries, as well as multiple skull fractures from a single fall, are unlikely. In order to differentiate abusive TBIs, clinicians also must rule out other non-intentional causes such as accidental trauma, continuous seizure activity, heart disease, metabolic disease, sepsis, and poisoning.