Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Child abuse by whiplash-shaking can lead to severe cerebral damage, neurological defects and mental retardation. Cerebral damage has been found with and without external evidence of head injury. We report the sonographic findings in two children after traumatization due to repetitive vigorous whiplash shaking. Cerebral sonography revealed cerebral edema at admission or within 48 hours thereafter. Follow-up studies demonstrated development of marked brain atrophy in both cases. The sonographic findings were confirmed by cranial computerized tomography. Doppler sonography was used to monitor cerebral perfusion by measuring intracranial blood flow. The clinical history of the patients demonstrates that cerebral sonography in combination with Doppler sonography not only serves as a diagnostic tool but also allows adjustment of therapy to the actual clinical status of the patient.
 ...
PMID:Battered child syndrome: cerebral ultrasound and CT findings after vigorous shaking. 140 84

A series of 6 infants subjected to child abuse is presented in whom contusional tears of subcortical white matter were detected during life by intracranial sonography. The sonographic appearances of this highly pathognomonic marker of shaking injury are described for the first time and their significance discussed. On the basis of our experience we suggest that high resolution cranial sonography is an extremely valuable part of the diagnostic work up in cases of suspected non-accidental injury.
 ...
PMID:Cerebral contusional tears as a marker of child abuse--detection by cranial sonography. 152 42

The suggestion has been made that a systematic approach to informing all parents of newborns about the dangers of shaking a baby is needed. The purpose of this study was to determine whether an educational campaign about the dangers of shaking a baby could influence parental knowledge, and would be perceived as helpful by new parents. A total of 15,708 parents of newborns in one urban county received a "Don't Shake the Baby" packet over a one year period. Moms ranged in age from 14 to 44 years, and 90% were white. A response postcard in the educational packet was returned by 3,293 parents (21%). More than three-fourths of respondents said the information was helpful to them, and 49% indicated that subsequent to reading the materials, they were less likely to shake their babies. Ninety-one percent said they thought other parents of newborns should read the material.
Child Abuse Negl 1992
PMID:"Don't shake the baby": the effectiveness of a prevention program. 154 22

The shaking of infants is an often underestimated cause of head-injuries in children. Without any external signs the diagnosis can be missed. The combination of subdural hematoma of typically interhemispheric site and retinal bleeding is pathognomonic of the shaked-baby syndrome. It is caused by acceleration-deceleration movements of the head. We present three patients with whiplash-shaken-injuries who were admitted to our hospital with impaired consciousness or in coma. With little external signs of injury more detailed investigations revealed other, older injuries suggesting previous abuse. The outcome was not favourable. Two of the children were discharged with minor or mild psychomotor retardation and one child was severely handicapped. As in the battered-child-syndrome a good history, assessing child specific and familial risk-factors and the socioeconomic background are most important to confirm a diagnosis. This type of injury is usually part of the spectrum of child abuse.
 ...
PMID:[Trauma caused by shaking the infant--a special form of child abuse]. 187 Jun

Serious injury can occur to children who are shaken, especially if the shaking is repeated or part of a pattern of abuse. Serial abuse in connection with children who are shaken and their siblings has important therapeutic and legal ramifications. From an ongoing study of child abuse and head trauma, 12 of 24 victims of shaking that resulted in intracranial injury were identified who had coexisting evidence of direct external trauma. Seventeen children (71%) had evidence of prior abuse, neglect, or both, including 8 who had multiple intracranial hemorrhages. Of the 21 families represented, 9 had more than one child, 3 (3%) of which had several siblings who had been victims of child abuse. Shaking of children usually is not an isolated event, as it frequently has been preceded by other types of abuse.
 ...
PMID:Serial abuse in children who are shaken. 223 52

Shaking as a mechanism of severe brain injury in infants has been challenged on a theoretical basis as insufficient to explain the magnitude of observed injuries. Computed tomography and magnetic resonance imaging, developed since shaken baby syndrome was first described, are helpful in establishing whether external trauma occurred for infants thought to have been shaken. We compiled data from 24 infants initially diagnosed as having shaken baby syndrome, including physical examination, roentgenograms, computed tomography or magnetic resonance imaging, and autopsy (when applicable). Half of the patients showed no evidence of direct impact, and evidence of external trauma was not predictive of a fatal outcome. These findings indicate that shaking by itself is sufficient to cause severe or fatal intracranial injury and that the shaken baby syndrome reflects a spectrum of such child abuse injuries that may include direct trauma or only shaking.
 ...
PMID:Incidence of impact trauma with cranial injuries ascribed to shaking. 234 56

During a four-year period, we saw 23 cases of child abuse with central nervous system involvement. Of these, five died and four were left with a substantial neurologic deficit as a result of injury. Of the 18 survivors, eight (44%) were removed from their home along with their siblings, one was placed in a sheltered environment with its mother, and nine (50%) were kept under surveillance. Six of the 12 patients with CT evidence of intracranial damage had no or minimal evidence of external cranial trauma. Although shaking as the major etiologic factor in neurologic impairment from child abuse has recently been questioned, our results implicate it as a common mechanism of injury. Every patient had a parent or guardian whose account of the mechanism of injury either changed from moment to moment or was inconsistent with the child's injury. Nine patients (39%) were known to have been seen previously by other physicians because of similar problems or other injuries consistent with child abuse. Early recognition of child abuse is paramount to saving not only the life of the affected child, but possibly the lives of siblings. Neurosurgeons should maintain a high index of suspicion for the diagnosis of child abuse.
 ...
PMID:Neurologic manifestations of child abuse. 281 21

The imaging modalities play a key role in the investigation and documentation of the battered child syndrome. The primary diagnostic imaging study in suspected child abuse is either a bone scan and x-ray series or a complete radiographic skeletal survey by x-ray series in babies and infants. In expected intracranial injuries, a CT scan of the head is mandatory; ultrasound has to be performed in order to exclude visceral lesions. The conventional radiographic examination permits us to identify the appearance of the injury (periosteal bleeding and ossification, metaphyseal fragmentation, fracture and epiphysiolysis) as well as the mechanism of the lesion: direct blow, twisting or traction of a limb, compression or shaking. In addition the age of the lesion can be derived from typical healing processes of the skeleton. Furthermore, non accidental skeletal malformations can be detected and may allow the exclusion of child abuse.
 ...
PMID:[Radiologic diagnosis of the battered child syndrome]. 309 35

We examined two children with presumed shaken baby syndrome. Both children suffered severe, indirect closed head trauma with intracranial hemorrhage, sharply increased intracranial pressure, and extensive neurologic damage. In addition to extensive retinal and preretinal hemorrhages, bilateral symmetric white ring-shaped retinal folds were seen encircling the macula outside the vascular arcades. These retinal folds may be a hallmark of shaking injuries in child abuse victims.
 ...
PMID:Retinal folds in the shaken baby syndrome. 317 59

Families were identified, in north-east Wiltshire (UK), (population 200,000), in which there was a pattern of two or more generations of child maltreatment and where there were also two or more children maltreated in the current generation (born between 1960 and 1980). These children had high rates of mental handicap, backwardness, and antisocial behaviour, and there were also characteristic patterns of emotional disturbance. The post-neonatal death rate for the 294 index children was very high, but higher still for their brothers and sisters. Some of the deaths, and at least 11 cases of violence-induced mental handicap (VIMH), were caused by characteristic types of child abuse - particularly violent shaking and throwing of infants, and secret suffocatory practices. There were very strong indications that larger numbers of children than the 11 proven VIMH cases had also suffered blunting of the intellect, physical complications such as epilepsy, and educational problems, as well as emotional and social maladjustment as the consequence of ill-treatment and neglect. Within the families, for children remaining at home, forms of ill-treatment and poor quality care persisted and ultimately affected most, or all, of the children in each family unit. Many families were chaotic, and within each family unit there were children frequently in care who suffered multiple placements, and who needed sustained specialist support throughout their childhood, encompassing a huge range of professional and other social support services. Such detail was generally underplayed or not accessible, and its full significance for children in each family could only be assessed by combining direct personal clinical involvement with record linkage methods, depending in turn on good co-operation from all agencies concerned wholly or partly with child protection.
 ...
PMID:Successive generations of child maltreatment. The children. 325 Jun 97


1 2 3 4 5 6 7 Next >>