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Simpler test may detect shaken baby syndrome

January 22, 2010 12:00:00 AM PST
Instead of a full brain scan to test for shaken baby syndrome, a simpler test may save babies precious time.Infants with an inflicted brain injury known as shaken baby syndrome can be easily misdiagnosed. The first symptoms, which consist of fussiness, crying or vomiting, can be mistaken for the flu or another illness, and these little patients can't tell doctors they've been injured.

As the hours pass without any medical intervention, complications begin to set in. One doctor is developing a test that could buy these little victims some life-saving time.

Morgan and Dawson Rath have always had a special bond as brothers. For Morgan, having a younger sibling with special needs also made him grow up faster than most.

"Morgan came up and asked me, 'Hey dad, when you and mom die, am I going to have to take care of Dawson? I'm not sure I can do that.' A 9-year-old shouldn't have to be thinking about stuff like that," said Steven Rath.

When Dawson was 14 months old, the Raths say a caregiver shook him, causing his brain to bleed, a condition commonly called shaken baby syndrome.

Brain injury in babies is often difficult to detect because a child may look normal on the outside, while the damage inside is taking a toll.

"The question for the doctor is how you pick out the one infant who is crying and fussy because they have a brain injury from the 99 others who don't have a brain injury," explains Dr. Rachel Berger, a pediatrician.

Right now, the only way doctors can confirm any injury is with a head scan, which isn't practical for every fussy baby. Berger is leading a team of researchers developing a quick blood test. It would detect chemicals in the body that are released when the brain is injured. A positive test would mean a child would benefit from a high-tech follow-up.

"Anything that could speed that process up that could give those doctors and nurses an edge in diagnosing and treating this," said Berger.

It would mean a change that could save some lives and improve the outcome for others.

Berger says the blood test alone would not be enough to determine if a child's brain injury was accidental or intentional, but it would be effective in conjunction with the blood test. It is currently being studied in a clinical trial.

Additional information on shaken baby syndrome

Shaken baby syndrome is a severe form of child abuse that occurs when an infant or small child has been violently shaken or their head has been impacted due to such actions. Every year, roughly 1,200 to 1,400 cases of this type of abuse occur in the United States. The National Institutes of Health says it only takes five seconds of shaking to cause shaken baby syndrome. It often occurs in children younger than two years old but is sometimes seen in kids up to five.

As a baby is shaken, their brain bounces against their skull, which causes bruising to the vital organ and also results in swelling, pressure and bleeding within the brain. The consequence can be permanent brain damage and even death. One in four babies who are victims of such abuse die. However, the other three that do survive require ongoing medical attention. In addition to damaging their brains, babies may also suffer injuries to their neck, spine and eyes.

Signs of abuse

According to the National Center on Shaken Baby Syndrome, immediately following such an episode the baby's breathing may stop or be interrupted, they may suffer seizures, vomit, their heart may stop or they may die. Some of signs a baby is a victim of shaken baby syndrome include the following, among others:

  • Lethargy/decreased muscle tone
  • Extreme irritability
  • Decreased appetite, poor feeding, or vomiting for no apparent reason
  • Lack of smiling or vocalization
  • Poor sucking or swallowing
  • Rigidity or posturing
  • Difficulty breathing
  • Seizures
  • Head or forehead appears larger than usual or soft-spot on head appears to be bulging
  • Inability to lift head
  • Inability of eyes to focus or track movement or unequal size of pupils