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The shaken baby syndrome

A clinical, pathological, and biomechanical study

Ann-Christine Duhaime, Thomas A. Gennarelli, Lawrence E. Thibault, Derek A. Bruce, Susan S. Margulies and Randall Wiser

that the fatal cases of the shaken baby syndrome in this series were all associated with evidence of blunt impact to the head. This preponderance of blunt trauma has also been found in at least one other series of nonaccidental head trauma in childhood in which the mechanism of injury was investigated. 9 It is of interest that in more than half of our fatal cases, no evidence of external trauma was noted on the initial physical examination, which helped to contribute to the diagnosis of “shaken baby syndrome.” Skull fractures and scalp contusions were found at

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.104.4.240 Nonaccidental head trauma as a cause of childhood death Patrick Graupman Ken R. Winston 4 2006 104 4 245 250 10.3171/ped.2006.104.4.245 PED.2006.104.4.245 Heavy water inhibiting the expression of transforming growth factor–β 1 and the development of kaolin-induced hydrocephalus in mice Junko Hatta Toshihisa Hatta Kouzo Moritake Hiroki Otani 4 2006 104 4 251 258 10.3171/ped.2006.104.4.251 PED.2006.104.4.251 Functional magnetic resonance imaging of the primary somatosensory cortex in piglets Ann-Christine Duhaime Andrew J. Saykin Brenna C. McDonald Carter P. Dodge

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Patrick Graupman and Ken R. Winston

received life support until a second confirmatory examination or test could be performed, and this may have been well beyond 24 hours of admission. Children who died between 1 and 7 days after admission had devastating neurological injuries that were clearly apparent, but the declaration of brain death was often not possible because of the retention of a brainstem reflex. These children were not removed from life support until a multidisciplinary team agreed that continuing support constituted futile care. Nonaccidental Head Trauma in the US At least 280 to 479

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Charles Kondageski, Dominic Thompson, Mandy Reynolds and Richard D. Hayward

was IVH in eight patients. The other causes were a congenital origin in four; meningitis in three; aqueductal stenosis and midbrain (tectal) hamartoma in two each; and choroid plexus papilloma, Dandy–Walker syndrome, vein of Galen aneurysm, and Pfeiffer syndrome in one patient each. One child had undergone shunt insertion for subdural effusions following nonaccidental head trauma. Table 1 also shows the combination of clinical and radiological data leading to the diagnosis of overdrainage, as well as the last valve implanted before the Strata. The time from the

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Matthew A. Adamo, Doniel Drazin and John B. Waldman

nonaccidental trauma group at the 32-month follow-up, these investigators found that 54% were described as severely handicapped and 31% were moderately handicapped, with 1 death. In the comparison group, 67% of the patients were believed to be normal, 11% were only mildly neurologically damaged, 11% had severe neurological damage, and 1 patient died. Similarly, Golden and Maliawan 4 showed that, in general, infants with nonaccidental head trauma generally had a poor outcome: 31% died, 23% had a good outcome, and the remainder recovered with neurological impairment of

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Matthew A. Adamo, Doniel Drazin, Caitlin Smith and John B. Waldman

accidental trauma, with a reported 15–38% mortality rate. 11 The goal of our study was to determine the incidence of accidental and nonaccidental head trauma in infants and toddlers in the Capital District Region of upstate New York, and to compare patient demographics, radiological findings, need for neurosurgical intervention, and outcomes between the groups, and determine what statistical differences may exist between them. Methods After obtaining approval from the Institutional Review Board at Albany Medical Center, we performed a retrospective chart review of

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Jeremiah Johnson, John Ragheb, Ruchira Garg, William Patten, David I. Sandberg and Sanjiv Bhatia

damage and contraction band necrosis. 23 , 30 , 41 , 48 , 50–52 Patients with NSM or TTC who survive the initial neurological insult and the acute phase of myocardial failure generally return to normal cardiac function within 5–14 days. Stunned myocardium is less well described in the pediatric population. There are 5 case reports of pediatric stunned myocardium and 2 were classified as NSM. One case followed a nonaccidental head trauma, and the second followed a repeat posterior fossa decompression for Chiari malformation Type I. 16 , 20 Both patients experienced

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Joel S. Katz, Chima O. Oluigbo, C. Corbett Wilkinson, Sean McNatt and Michael H. Handler

initial referral. This low prevalence of cervical spine injuries in our particular patient population corroborates evidence in the literature. In a similar study Kim et al. 16 reported that of 42 patients less than 2 years of age with low-impact head injuries reviewed in their institution, none was found to have CSIs. It is pertinent to note that the mechanism of injury in the 2 patients with CSIs was NAT. Several authors have reported CSIs in infants who have suffered NAT. 8 , 10 This association of CSI with nonaccidental head trauma in this infant population is

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Mary I. Huang, Mary Ann O'Riordan, Ellen Fitzenrider, Lolita McDavid, Alan R. Cohen and Shenandoah Robinson

formal analysis of this trend has been previously reported in the peer-reviewed literature. Our objective in this study was to identify infants 0–2 years old with NAHT over the recent nonrecession and recession periods; compare differences in demographics, incidence rates, and severity; and present these results in the context of the unemployment rates represented by our sample. Methods Nonaccidental Head Trauma Data In our Level I Pediatric Trauma Center, all children with traumatic injuries admitted to Rainbow Babies and Children's Hospital are documented

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microsurgical cyst excision and shunting for treating intracranial arachnoid cysts Michelangelo Gangemi Vincenzo Seneca Giuseppe Colella Valentina Cioffi Alessia Imperato Francesco Maiuri 8 2011 8 2 158 164 10.3171/2011.5.PEDS1152 2011.5.PEDS1152 Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children's Hospital experience Manish N. Shah Alex A. Kane J. Dayne Petersen Albert S. Woo Sybill D. Naidoo Matthew D. Smyth 8 2011 8 2 165 170 10.3171/2011.5.PEDS1128 2011.5.PEDS1128 Increased incidence of nonaccidental head trauma in