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Tests and diagnosis
By Mayo Clinic staffA child who's been forcefully shaken may need to be examined by a number of medical specialists, as well as an expert in child abuse. Various tests may be needed to detect injuries, such as:
- Computerized tomography (CT) scan. A CT scan uses X-ray images to provide cross-sectional images of a child's brain. This test can help detect injuries that need urgent intervention.
- Magnetic resonance imaging (MRI). MRI uses a powerful magnetic field and radio waves to create detailed images of a child's brain. Because MRI is difficult to perform on a child who's unstable, it's usually done two to three days after the injury.
- Skeletal survey. A series of skeletal X-rays — possibly including the arms, hands, legs, feet, spine, ribs and skull — may be used to gauge whether fractures are accidental or purposeful and find previous fractures.
- Ophthalmological exam. An eye exam can reveal bleeding and other eye injuries.
- Blood tests. Some metabolic and genetic disorders, as well as bleeding and clotting disorders, can lead to symptoms that may mimic shaken baby syndrome. Blood tests can help rule out some of these conditions.
Depending on the extent of the injuries, the baby may need to be monitored in a pediatric intensive care unit.
References
- Abusive head trauma: Shaken baby syndrome. American Academy of Pediatrics. http://www.healthychildren.org/English/safety-prevention/at-home/Pages/Abusive-Head-Trauma-Shaken-Baby-Syndrome.aspx. Accessed Aug. 5, 2011.
- Never shake your baby! March of Dimes. http://www.marchofdimes.com/prematurity/28127.asp. Accessed Aug. 5, 2011.
- NINDS shaken baby syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/shakenbaby/shakenbaby.htm. Accessed Aug. 5, 2011.
- Christian C, et al. Epidemiology, mechanisms, and types of abusive head injury in infants and children. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Christian C, et al. Evaluation and diagnosis of abusive head injury in infants and children. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Barnes PD. The imaging of nonaccidental injury and the mimics: Issues and controversies in the era of evidence-based medicine. Radiologic Clinics of North America. 2011;49:205.
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