Visual Effects of Shaken Baby Syndrome

1
Visual Effects of Shaken Baby Syndrome
2
What is Shaken Baby Syndrome (SBS)?

• SBS is caused by the vigorous shaking of an
  infant or child by the shoulder, arms or legs. A
  single shaking episode results in
  whiplash-induced bleeding in and around the brain
  and can lead to death or permanent neurological
  damage.
• The most common reason for shaking a baby is that
  the baby wouldn't stop crying or fussing.

3
What Happens

• The brain rotates within the skull cavity,
  injuring or destroying brain tissue.
• When shaking occurs, blood vessels feeding the
  brain can be torn, leading to bleeding around the
  brain.
• Blood pools within the skull, sometimes creating
  more pressure within the skull and possibly
  causing additional brain damage.
• Retinal (back of the eye) bleeding is very common

4
Common indicators of SBS in children

• Subdural hematoma (collecting of blood between
  the brain and the skull)
• Cerebral edema (swelling of the brain)
• Retinal hemorrhage (bleeding behind the eyes)

5
Common Effects of SBS on the Visual System

• When a young baby is shaken, the blood vessels of
  the eye as well as of the brain hemorrhage,
  leading to loss of sight. Most common visual
  defects resulting from SBS include
• Retinal hemorrhaging (bleeding)
• Retinal detachment
• Retinoschisis.

6
Retinal Hemorrhage

• With a retinal hemorrhage the blood vessels of
  the retina fill with blood and burst. The effects
  of this depend on the size and degree of bleeding
  that occurs. Effects may include
• Blurred vision
• Light flashes
• Floaters that may be dark or red
• Complete loss of some visual fields

7
Retinal detachment

• When the retina detaches, it separates from the
  back wall of the eye and is removed from its
  blood supply. The retina will degenerate and lose
  its ability to function if it remains detached.
  Central vision will be lost if the macula remains
  detached.

8
Traumatic retinoschisis

• A particularly severe form of retinal injury in
  SBS, traumatic retinoschisis, is characterized by
  a dome-shaped cavity in the macula with elevated
  perimacular folds at the periphery of the cavity.
• This is where the retina becomes torn and a
  section hangs apart from the rest.

9
Long-Term Consequences of SBS

• Psychological disabilities such as mood swings,
  anxiety, depression and behavioural issues.
• Cognitive disabilities including learning
  difficulties, planning impairment, memory loss,
  and developmental delays.
• Physical disabilities such as muscle spasms,
  partial or total blindness, hearing impairment,
  paralysis, cerebral palsy, and seizures.

10
Prognosis

• The prognosis for children afflicted with SBS is
  usually not good. A significant number of babies
  who are mistreated die.
• Many others suffer serious, long-term damage that
  will stay with them throughout their lives.
  Injuries that cause blindness, mental
  retardation, or loss of motor (muscular) control,
  for example, are permanent. They can not be
  repaired. Rehabilitation, however, can help a
  child learn to live and cope with their new
  disability.

11
Prevention

• The only way to prevent shaken baby syndrome is
  by educating adults.
• A common reason given by adults for this type of
  abuse is frustration with a crying baby. Parents
  and caregivers can be taught how to deal with
  this frustration. One general rule is to leave a
  crying baby alone until the adult has calmed
  down. Possible reasons for the baby's discomfort
  should then be considered. A warm bottle, dry
  diaper, soft music, a bath, or a ride in a swing
  may calm the child, which in turn may calm the
  adult.
• Adults should also be aware that a baby who cries
  excessively may have a medical disorder and
  should be examined by a doctor.

12
(No Transcript)