Shaken baby syndrome is difficult to diagnose unless someone accurately describes what happens. Physicians often report that a child with possible shaken baby syndrome is brought for medical attention due to falls, difficulty breathing, seizures, vomiting, altered consciousness, or choking. The caregiver may report that the child was shaken to try to resuscitate it. Babies with severe or lethal shaken baby syndrome are typically brought to the hospital unconscious with a closed head injury.
To diagnose shaken baby syndrome, physicians look for bleeding in the retina of the eyes, blood in the brain, or increased head size indicating buildup of fluid in the tissues of the brain. Damage to the spinal cord and broken ribs from the baby being grasped too hard are other signs of shaken baby syndrome. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans can reveal injuries in the brain but are not regularly used because of their expense.
A milder form of this syndrome may be missed or misdiagnosed. Subtle symptoms which may be the result of shaken baby syndrome are often attributed to mild viral illnesses, feeding dysfunction, or infant colic. These include a history of poor feeding, vomiting, or flu-like symptoms with no accompanying fever or diarrhea, lethargy, and irri tability over a period of time. Without early medical intervention, the child may be at risk for further damage or even death, depending on the continued occurrences of shaking.
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