Talk:Abnormal Development - Shaken Baby Syndrome

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Cite this page: Hill, M.A. (2019, August 18) Embryology Abnormal Development - Shaken Baby Syndrome. Retrieved from


Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review

BMC Neurol. 2015 Feb 4;15:7. doi: 10.1186/s12883-015-0259-7.

Chan V1,2,3, Thurairajah P4, Colantonio A5,6,7.


BACKGROUND: Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. METHODS: The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. RESULTS: A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth. CONCLUSION: This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.

PMID 25648197


Shaken baby syndrome and a triple-dose strategy for its prevention

J Trauma. 2011 Dec;71(6):1801-7.

Stewart TC, Polgar D, Gilliland J, Tanner DA, Girotti MJ, Parry N, Fraser DD. Source Trauma Program, London Health Sciences Centre and Children's Hospital, London, ON, Canada.


OBJECTIVES: Inflicted traumatic brain injury associated with Shaken Baby Syndrome (SBS) is a leading cause of injury mortality and morbidity in infants. A triple-dose SBS prevention program was implemented with the aim to reduce the incidence of SBS. The objectives of this study were to describe the epidemiology of SBS, the triple-dose prevention program, and its evaluation. METHODS: Descriptive and spatial epidemiologic profiles of SBS cases treated at Children's Hospital, London Health Sciences Centre, from 1991 to 2010 were created. Dose 1 (in-hospital education): pre-post impact evaluation of registered nurse training, with a questionnaire developed to assess parents' satisfaction with the program. Dose 2 (public health home visits): process evaluation of additional education given to new parents. Dose 3 (media campaign): a questionnaire developed to rate the importance of factors on a 7-point Likert scale. These factors were used to create weights for statistical modeling and mapping within a geographic information system to target prevention ads. RESULTS: Forty-three percent of severe infant injuries were intentional. A total of 54 SBS cases were identified. The mean age was 6.7 months (standard deviation, 10.9 months), with 61% of infant males. The mean Injury Severity Score was 26.3 (standard deviation, 5.5) with a 19% mortality rate. Registered nurses learned new information on crying patterns and SBS, with a 47% increase in knowledge posttraining (p < 0.001). Over 10,000 parents were educated in-hospital, a 93% education compliance rate. Nearly all parents (93%) rated the program as useful, citing "what to do when the crying becomes frustrating" as the most important message. Only 6% of families needed to be educated during home visits. Locations of families with a new baby, high population density, and percentage of lone parents were found to be the most important factors for selecting media sites. The spatial analysis revealed six areas needed to be targeted for ad locations. CONCLUSIONS: SBS is a devastating intentional injury that often results in poor outcomes for the child. Implementing a triple-dose prevention program that provides education on crying patterns, coping strategies, and the dangers of shaking is key to SBS prevention. The program increased knowledge. Parents rated the program as useful. The media campaign allowed us to extend the primary prevention beyond new parents to help create a cultural change in the way crying, the primary trigger for SBS, is viewed. Targeting our intervention increased the likelihood that our message was reaching the population in greatest need.

PMID 22182892

Traumatic brain injury and shaken baby syndrome

Acta Med Port. 2011 Sep;24(5):805-8. Epub 2011 Dec 29.

Paiva WS, Soares MS, Amorim RL, Andrade AF, Matushita H, Teixeira MJ. Source Division of Neurosurgery. University of São Paulo Medical School. São Paulo. Brasil.


Shaken baby syndrome is a serious form of physical child abuse, which is frequently overlooked. It is defined as vigorous manual shaking of an infant who is being held by the extremities or shoulders, leading to whiplashinduced intracranial and intraocular bleeding and no external signs of head trauma. This syndrome is seen most commonly in children under 2 years, mainly in children under 6 months. This article summarizes issues related to clinical presentation, diagnosis, risk factors, and interventions for healthcare professionals.

PMID 22525633

A public hearing "Shaken baby syndrome: guidelines on establishing a robust diagnosis and the procedures to be adopted by healthcare and social services staff". Guidelines issued by the Hearing Commission

Ann Phys Rehabil Med. 2011 Dec;54(9-10):600-25. Epub 2011 Nov 4.

[Article in English, French] Laurent-Vannier A, Nathanson M, Quiriau F, Briand-Huchet E, Cook J, Billette de Villemeur T, Chazal J, Christophe C, Defoort-Dhellemmes S, Fortin G, Rambaud C, Raul JS, Rey-Salmon C, Sottet F, Vieux E, Vinchon M, Willinger R; French Society of Physical Medicine and Rehabilitation; French National Authority for Health. Source Service de rééducation des pathologies neurologiques acquises de l'enfant, hôpitaux de Saint-Maurice, 14, rue du val d'Osne, 94415 Saint-Maurice cedex, France.

PMID 22118914