Shaken Baby Syndrome - Exams and Tests
Shaken baby syndrome can be difficult to diagnose. The diagnosis can be complicated
- Vague symptoms. Irritability, sluggishness,
vomiting, and a poor appetite that are often symptoms of shaken baby syndrome
also occur with common illnesses, such as the flu, ear infections, stomach flu
(gastroenteritis), and kidney
- The lack of visible signs of injury, such as bruises or
- One or both parents not knowing that their baby was
- Caregivers not admitting when they have harmed a baby. They
may make up stories to explain why a child has signs of trauma.
- Caregivers not seeking medical care right away after they have
injured the child. This commonly occurs because the caregiver wants to avoid
responsibility and hopes symptoms will go away after the child rests.
Doctors may suspect shaken baby syndrome when the adults
are vague or misleading about what has happened to the child, especially when
symptoms are severe and indicate intentional head injury. Diagnosis is
medical history with a detailed time line of symptoms.
This history includes noting changes in the child's behavior and when they
occurred. This information helps doctors figure out when an injury was likely
to have occurred.
physical exam to look for signs of injury and
increased blood pressure.
- Tests to help doctors identify injuries
that are commonly associated with shaken baby syndrome.
computed tomography (CT) scan generally is the first
test that is done to determine the presence of brain injury. Scans may be
repeated to monitor the condition of the child's brain.
magnetic resonance imaging (MRI) test may be used
along with a CT scan. Images from this test may help doctors understand more
about a child's injuries, such as when they are likely to have occurred.
lumbar puncture (LP) allows a doctor to look for blood
in the fluid around the child's spinal cord. The fluid may also be examined for
signs of infection that may indicate
meningitis as a possible cause for a child's
- X-rays are taken to check for broken
bones. X-rays may be repeated 2 weeks later because breaks in bones are
sometimes not seen until they begin to heal (healing begins 7 to 10 days after
a break). The types of X-rays usually taken are:
A child may have blood tests to rule out other conditions,
such as rare blood disorders and metabolic conditions, or to check for internal injuries.
Each state has its own reporting
child abuse or neglect, which includes shaken baby
syndrome. In general, a doctor who suspects shaken baby
syndrome must notify local child welfare officials and law enforcement
agencies. The person who is suspected of injuring the baby is then questioned
and evaluated along with anyone else who provided care for the child. Any other
children who were cared for by the suspect should be examined. Older children
are interviewed. Children age 3 years and younger should have skeletal X-rays
The authorities' primary goal is to protect the baby and
other children in the home from further injury. The person who caused the
injury may be legally charged and tried for assault.