Baby sitter held in shaking incident
Here is another tragic story of a babysitter abusing a baby and causing brain injury. Shaken Baby Syndrome is a very real risk for parents and their childrren. Read about the case here.
Anatomy and pathophysiology
People under the age of three years are especially susceptible to brain damage from shaking. This is due to several anatomical factors. Their heads are bigger and weigh more with respect to their bodies than adults' heads, and their neck muscles are weak and cannot prevent violent motions. Infants' brains are not fully myelinated; myelin sheaths form in childhood and are complete in adolescence. The water content of the brain is reduced as neurons gain myelin during development, so babies have a greater percentage of brain water than adults do.[10] Because of this higher water content, children's brains are softer and are much more susceptible to acceleration-deceleration injuries and diffuse axonal injury.
The underlying injury in SBS is typically diffuse axonal injury.
In 2004, a Scottish database collected data for five years on cases of suspected non-accidental head injury diagnosed after a multiagency assessment and included cases with uncoerced confessions of perpetrators and criminal convictions. Several patterns appeared allowing the categorization of the cases into four predominant types: Hyperacute encephalopathy (6% of all cases); Acute encephalopathy (53% of cases (SBS)); Subacute non-encephalopathic presentation (19% of cases); Chronic extracerebral presentation (22% of cases). Infants can be traumatically injured in many ways, and many instances are unwitnessed. Thus the generic term non-accidental head injury or inflicted traumatic brain injury is occasionally used in preference to shaken baby syndrome, which implies a specific mechanism of injury.[12] An earlier detailed neuropathological study was publish in the UK in 2001, which included immunocytochemistry for microscopic damage.[
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