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Shaken Baby Syndrome 14 December 2010
 
Introduction ,[object Object],[object Object],[object Object]
 
1970s ,[object Object],[object Object],Caffey J. On the theory and practice of shaking infants.  Am J Dis Child  1972;124:161–9 .
Pathophysiology ,[object Object]
Etiology ,[object Object],[object Object],[object Object]
Etiology
Presenting History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Birth History ,[object Object],[object Object]
Clinical Signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Pathogenesis of Clinical Findings ,[object Object],[object Object]
Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations
Outcome ,[object Object],[object Object],[object Object]
Mechanisms of Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanisms of Injury: Mechanical Forces ,[object Object],[object Object],[object Object],[object Object],[object Object]
Shearing injury ,[object Object],[object Object]
It allows the young child’s brain to  rotate more readily  in response to head acceleration or deceleration than occurs after the skull base has developed more prominent bony ridges and concavities The shallow skull base It produces  instability of the head , which allows  greater movement of the head and brain  when acted on by acceleration–deceleration forces. The large heavy head mounted on the weak neck The large number of neurons  without glial or dendritic  connections, and the  small  axonal size  predispose  the young brain to  shearing injury  by creating a soft consistency. The paucity of the myelin sheath of axons Impact force  is  more effectively transferred  through the thin pliant skull and across the large and shallow subarachnoid space of a  young child’s head. Thinness and pliability of the skull with large heavy head Mechanism of injury Characteristic
Mechanisms Of Injury Accelerating skull responding to  rotational  forces brain moves within the cranial cavity non-uniformity and different consistencies of the brain structures ,[object Object],[object Object],[object Object],[object Object],Disruptions of the axonal processes Lesser forces disrupt the most external junctures  Greater forces disrupt deeper junctures Diffuse axonal injury
Diffuse Brain Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diffuse Brain Injury ,[object Object],[object Object],[object Object]
Diffuse Brain Injury ,[object Object],[object Object],[object Object]
Brain Swelling ,[object Object],[object Object],[object Object],[object Object]
Subdural Hemorrhage ,[object Object],[object Object],[object Object],[object Object]
Subdural Hemorrhage ,[object Object],[object Object],[object Object]
Subarachnoid Hemorrhage ,[object Object],[object Object],[object Object],[object Object]
Chronic Subdural Hematoma ,[object Object],[object Object],[object Object],[object Object]
Chronic Subdural Hematoma ,[object Object],[object Object],[object Object],[object Object]
Chronic Subdural Hematoma ,[object Object],[object Object],[object Object],[object Object]
Retinal Hemorrhages ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Retinal Hemorrhages ,[object Object],[object Object],[object Object],[object Object],[object Object]
Timing Of Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SBS diagnosis: Dilemma ,[object Object],[object Object],[object Object],[object Object]
SBS diagnosis: Dilemma ,[object Object],[object Object],[object Object]
Fatal child abuse :Pathologist’s Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fatal child abuse :Pathologist’s Findings ,[object Object],[object Object],[object Object],[object Object]
Q: Whether such apparently innocent practices as tossing a baby into the air and other playful maneuvers might cause brain damage by a similar shaking mechanism? ,[object Object]
CONCLUSION ,[object Object],[object Object],[object Object],[object Object]
Thank You

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Shaken baby syndrome

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  • 21. It allows the young child’s brain to rotate more readily in response to head acceleration or deceleration than occurs after the skull base has developed more prominent bony ridges and concavities The shallow skull base It produces instability of the head , which allows greater movement of the head and brain when acted on by acceleration–deceleration forces. The large heavy head mounted on the weak neck The large number of neurons without glial or dendritic connections, and the small axonal size predispose the young brain to shearing injury by creating a soft consistency. The paucity of the myelin sheath of axons Impact force is more effectively transferred through the thin pliant skull and across the large and shallow subarachnoid space of a young child’s head. Thinness and pliability of the skull with large heavy head Mechanism of injury Characteristic
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