Shaken baby syndrome. Imaging methods for the recognition of a severe form of infant maltreatment

Journal article

Background. Shaking babies causes severe cerebral lesions, resulting in death or lasting neurological deficits, without external signs of violence. The identification of shaken babies is of outstanding forensic importance to avoid further assaults by their guardians. Methods. CT and MRI scans of four patients with probable or proven non-accidental shaking injuries according to Duhaimes classification scheme were evaluated retrospectively. Results. All patients had extensive cortical and subcortical lesions with a parietal and occipital predominance. The basal ganglia were spared. In those three patients with diffusion-weighted MRI shortly after the onset of symptoms, the lesions showed restricted diffusion of protons. On follow-up, all patients developed extensive cortical and subcortical necroses, cerebral atrophy and hemorrhagic cortical transformation. The diffusion abnormalities did not persist longer than 3 weeks. Conclusions. Imaging features of the shaken baby syndrome are dominated by ischemic and hypoxic cerebral lesions. The best imaging modality for these patients is MRI including diffusion-weighted images, because it is most sensitive for the typical lesion pattern in this form of non-accidental trauma. © Springer Medizin Verlag 2005.

Authors: Küker, W; Schöning, M; Krägeloh-Mann, I; Nägele, T

• Journal: Monatsschrift fur Kinderheilkunde
• Volume: 154
• Issue: 7
• Pages: 659-668
• Publication date: 2006-07-01
• DOI: 10.1007/s00112-004-1043-8
• ISSN: 0026-9298
• Language: German
• Keywords: Diffusion-weighted imaging; Non-accidental trauma; MRI; Shaken baby syndrome