cleveland clinic

Mar 29, 2025

Shaken Baby Syndrome (Abusive Head Trauma): Symptoms, Causes & Treatment

Overview

  • Definition: Shaken Baby Syndrome, also known as Abusive Head Trauma, is a severe form of child abuse resulting from violently shaking a child.
  • Effects: Causes swelling, bruising, and bleeding in the brain leading to potential brain damage, lifelong disabilities, or death.
  • Causes: Often occurs when a caregiver is frustrated with a crying baby.

Why Shaken Baby Syndrome Happens

  • Crying: Normal behavior for babies; caregivers might shake the baby out of frustration believing it will stop the crying.
  • Caregiver Stress: High stress or lack of knowledge about the dangers of shaking.

Affected Population

  • Victims: Often affects infants less than 1 year old, particularly between 2 and 8 months.
  • Perpetrators: Typically caregivers with a direct or indirect connection to the child.

Prevalence

  • Statistics: 600 to 1,400 cases in the U.S. annually; leading cause of child abuse death in children under 5.

Effects on the Baby

  • Medical Issues:
    • Subdural Hematoma: Blood between the brain and dura.
    • Subarachnoid Hemorrhage: Bleeding between the brain and arachnoid membrane.
    • Brain and Eye Damage: Potential for brain damage and retinal hemorrhages.
    • Neck and Spinal Cord Damage: Injuries to cervical spinal nerves.
    • Fractures: Including skull and rib fractures.

Symptoms and Causes

  • Immediate Symptoms: Unconsciousness, seizures, shock.
  • Other Symptoms:
    • Lack of interaction (not smiling).
    • Irritability and vomiting.
    • Feeding problems and lethargy.
    • Breathing difficulties and skin discoloration.
    • Physical signs like bruises and bulging soft spots on the head.
    • Motor and sensory issues such as tremors and inability to focus.

Diagnosis and Tests

  • Challenges in Diagnosis: Symptoms overlap with other conditions.
  • Diagnostic Methods:
    • Imaging Tests: X-rays, CT scans, MRI scans to identify brain swelling, bleeding, or fractures.
    • Eye Examination: To detect retinal bleeding.

Management and Treatment

  • Immediate Medical Attention: Necessary for any symptoms.
  • Hospital Treatment: Medication and observation; life-saving measures for severe cases.

Prevention

  • Understanding Crying: Recognizing crying as normal and exploring other ways to console a baby.
  • Support for Caregivers: Asking for help from trusted individuals when feeling overwhelmed.
  • Education: Ensuring all caregivers are aware of the dangers of shaking.

Outlook / Prognosis

  • Serious Condition: High mortality and disability rates; some may develop developmental delays, disabilities, or lifelong conditions like cerebral palsy or epilepsy.

A Note from Cleveland Clinic

  • Preventability: Shaken Baby Syndrome is entirely preventable with proper knowledge and support for caregivers.

These notes provide an overview of the critical aspects of Shaken Baby Syndrome, including the symptoms, causes, diagnosis, treatment, and prevention strategies.