Sunday, December 19, 2010

Shaken Baby Syndrome

2 comments:

Anonymous said...

Thanks for your post. I am a paediatrician. I would like to seek your expert opinion on traumatic brain injury. 1) Is there a consensus on the height of a fall which would lead to fatal head injury in an infant of few months old? 2)Is it possible for a head injury that caused skull fracture with subdural and subarachnoid haemorrahge to occur without causing a scalp wound or bruise? Thanks for your help in advance. I would appreciate if you can provide reference as well. Thanks again.

Dr. Liew said...

Hi peddoc212. As far as i know, there is no such consensus available. However, i believe the degree of injury is not only depending on the height, but also the weight of the child, the mechanism of fall and the direction of the fall in relation to the head and the neck position as well. The risk of fatality also depending on the degree of secondary brain injury. Subdural and subarachnoid hemorrhage can occur without scalp wound or bruise. This information can be found in many articles available. However, most fracture associated with scalp bruise/hematoma. Base of skull fracture can happen without any scalp bruise, for sure. I believe even convexity skull fracture can happen without any scalp bruise since the skull bone in infant is very thin, but must be very rare. There is a good article for your reference; http://www.hawaii.edu/medicine/pediatrics/pedtext/s18c13.html

Thanks for you comment.