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In 1974 John Caffey described a form of abuse in infants which he called "The Whiplash Shaken Infant Syndrome." This syndrome involves vigorous manual shaking of infants by the extremities or shoulders, with whiplash-induced intracranial and intraocular bleeding, but with no external signs of head trauma. This article reviews the literature on whiplash shaken infant syndrome since Caffey's original review. The bulk of this literature focuses on the use of cranial computed tomography in the diagnosis of head injury in infants. Many questions remain regarding the incidence of this syndrome, and the long term morbidity resulting from this type of injury in infants. Caffey's recommendations for routine, regular examinations of the ocular fundi in all babies, and for a massive public educational program on the hazards of shaking infants have yet to be carried out.
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PMID:The whiplash shaken infant syndrome: what has been learned? 351 79

Shaken baby syndrome is the most common cause of death or serious neurological injury resulting from child abuse. It is specific to infancy, when children have unique anatomic features. Subdural and retinal haemorrhages are markers of shaking injury. An American radiologist, John Caffey, coined the name whiplash shaken infant syndrome in 1974. It was, however, a British neurosurgeon, Guthkelch who first described shaking as the cause of subdural haemorrhage in infants. Impact was later thought to play a major part in the causation of brain damage. Recently improved neuropathology and imaging techniques have established the cause of brain injury as hypoxic ischaemic encephalopathy. Diffusion weighted magnetic resonance imaging is the most sensitive and specific method of confirming a shaking injury. Families of children with subdural haemorrhages should be thoroughly investigated by social welfare agencies.
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PMID:Shaken baby syndrome. 1250 90

In the recent decades research on child abuse has grown impressively. Four types of child abuse: physical, psychological (emotional), sexual, and neglect have been clinically observed and defined. In 1972, John Caffey, a pediatric radiologist, published an article on the theory and practice of the abusive shaking of infants. This was followed, in 1974, with a second article on the whiplash shaken baby syndrome (SBS). Shaken baby syndrome, is caused by the violent shaking of a child with or without contact between the child's head and a hard surface. Such contact may result in head trauma, including subdural hematoma, diffuse axonal injury and retinal hemorrhage. The annual estimated rate of inflicted traumatic brain injury is 30 cases per 100,000 children aged 1 year of younger. Shaken baby syndrome often occurs after shaking in response to crying bouts. In 2001, an estimated 903,000 children were victims of SBS. Additionally, 1300 children were fatally injured from SBS the same year. The ability to detect SBS is difficult secondary to under reporting and misdiagnosis. There is no established set of symptoms that indicate SBS.
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PMID:[The shaken baby syndrome as a kind of domestic abuse]. 2071 55

In the decades since Dr. John Caffey described a series of children with chronic subdural hematoma and long bone fractures, there has been a substantial increase in the medical recognition of various forms child abuse. In the United States, the term shaken baby syndrome was coined to explain a constellation of injuries assumed to be the result of violent shaking of infants. After improved understanding of the variety of mechanisms that occur when children are abused, abusive head trauma (AHT) has become the recommended terminology. AHT is a more comprehensive term that reflects the brain injuries that children suffer as the result of abuse. AHT continues to include shaking as a mechanism of injury as well as shaking with impact, impact alone, crushing injuries or combinations of several mechanisms. The medical community in the United States has led the way in developing new terminology and research to describe this unique and devastating form of abuse. The globalization of medicine and rapid information transfer has resulted in AHT becoming well-recognized internationally as a form of serious and fatal child abuse. This paper will review the historical basis in the United States for the diagnosis of AHT. We will also review some of the current international issue in epidemiology, diagnosis, legal processes and outcomes in selected countries/regions where child abuse physicians are actively involved in the evaluation of AHT.
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PMID:International issues in abusive head trauma. 2550 37