Keywords
Pediatric Abusive Head Trauma
Violence against children
Neurology
How to Cite
Abstract
Shaken Baby Syndrome (SBS), or Pediatric Abusive Head Trauma, is a consequence of the recurrent practice of child violence, a major social aspect in developing countries. In this regard, the present paper analyzed the respective syndrome, given the recurrence of cases of child abuse in the global context with possible pathological implications, presenting characteristics associated with its epidemiology, pathophysiology, clinical aspects, diagnostic approaches and therapeutic possibilities. Hence, a literature review was carried out on the Public Medline (PubMed), Scientific Electronic Library Online (SciELO) and Google Scholar databases using health sciences descriptors (MESH descriptors) referring to the issue, in addition to gray literature, filtering a time period of 20 years. Epidemiologically, it is transpicuous that those most affected are children aged between 0 and 5 years and residents of underdeveloped countries. As for syndromic origins, it is emphasized that this is a direct result of sudden movements, which is a characteristic of some type of physical violence suffered by the child. On this subject, veins generally rupture due to compression caused by the force of the impact, which generates bruises and increases Intracranial Pressure (ICP). Among the most frequent clinical findings, the presence of cerebral edema, subdural hemorrhages and retinal hemorrhages stands out. As diagnostic alternatives, it is necessary to combine both laboratory tests and imaging tests, such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Regarding therapeutic options, it is mandatory to maintain the airway with immobilization to prevent complications, recurrent measurement of ICP and, in more severe cases, surgical procedures, for example craniotomy. Finally, it was concluded that child abuse represents an intrinsic aspect of the emergence of cases of Shaken Baby Syndrome, being associated with socioeconomic disparities. However, with the introduction and union of different exams it is possible to proceed quickly with an assertive therapeutic approach, thus guaranteeing a higher recovery rate.
References
CARTOCCI, G. et al. Shaken Baby Syndrome: Magnetic Resonance Imaging Features in Abusive Head Trauma. Brain Sci. 2021 Feb 1;11(2):179. DOI: https://doi.org/10.3390/brainsci11020179.
DE ARZA, M. J. I. The pandemic of child abuse. Archivos Argentinos De Pediatria, v. 121, n. 5, p. e202310134, 1 out. 2023. DOI: https://doi.org/10.5546/aap.2023-10134.eng.
DUHAIME, A. C.; CHRISTIAN, C. W. Abusive head trauma: evidence, obfuscation, and informed management. Journal of Neurosurgery: Pediatrics, v. 24, n. 5, p. 481–488, nov. 2019. DOI: https://doi.org/10.3171/2019.7.PEDS18394.
FÓRUM BRASILEIRO DE SEGURANÇA PÚBLICA (FBSP). Anuário Brasileiro de Segurança Pública (2023). São Paulo: FBSP, 2023. Disponível em: <https://forumseguranca.org.br/wp-content/uploads/2023/07/anuario-2023.pdf>. Acesso em: 23 jun. 2024.
GORDY, C. & KUNS, B. Pediatric abusive head trauma. Nursing Clinics, v. 48, n. 2, p. 193-201, 2013. Disponível em: https://www.nursing.theclinics.com/article/S0029-6465(13)00014-5/abstract.
HUNG, K. L. Pediatric abusive head trauma. Biomedical Journal, v. 43, n. 3, abr. 2020. DOI: https://doi.org/10.1016/j.bj.2020.03.008.
JOYCE, T.; GOSSMAN, W.; HUECKER, M. R. Pediatric Abusive Head Trauma. StatPearls, Flórida, 22 maio 2023. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK499836/. Acesso em: 23 jun. 2024.
KALELIOGLU, T. Non-accidental trauma (illustration). Radiopaedia, 7 jun. 2022. Disponível em: https://doi.org/10.53347/rID-146626. Acesso em: 21 jun. 2024.
KWAK, Y. H. Diagnosis of Abusive Head Trauma: Neurosurgical Perspective. Journal of Korean Neurosurgical Society, v. 65, n. 3, p. 370–379, 1 maio 2022. DOI: https://doi.org/10.3340/jkns.2021.0284.
KOCHANEK, P. M. et al. Management of Pediatric Severe Traumatic Brain Injury. Pediatric Critical Care Medicine, v. 20, n. 3, p. 269–279, mar. 2019. DOI: https://doi.org/10.1097/pcc.0000000000001737.
LAURENT‐VANNIER, A. Shaken Baby Syndrome (SBS) or Pediatric Abusive Head Trauma from Shaking: Guidelines for Interventions During the Perinatal Period from the French National College Of Midwives. Journal of Midwifery & Women’s Health, v. 67, n. S1, nov. 2022. Disponível em: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jmwh.13427.
LEE, W. J.; LIM, Y. C.; YOON, S. H. Abusive Head Traumas in 4 Infants. Korean Journal of Neurotrauma, v. 16, n. 2, p. 246, 2020. DOI: https://doi.org/10.13004%2Fkjnt.2020.16.e30.
LEE, A. C. et al. Traumatismo cranioencefálico abusivo pediátrico: relato de caso e revisão da literatura. Saúde Ética & Justiça, v. 26, n. 2, p. 51–56, 29 dez. 2021. DOI: https://doi.org/10.11606/issn.2317-2770.v26i2p51-56.
LEE, S. G. et al. Factors Associated With Subdural Hygroma Following Mild Traumatic Brain Injury. Korean J Neurotrauma. 2022 Oct 24;18(2):230-237. doi: https://doi.org/10.13004/kjnt.2022.18.e61.
LOPES, N. R. L.; EISENSTEIN, E.; WILLIAMS, L. C. A. Abusive Head Trauma in Children: A Literature Review. Jornal de Pediatria, v. 89, n. 5, p. 426–433, set. 2013. DOI: https://doi.org/10.1016/j.jpedp.2013.01.012.
MAIESE, A. et al. Pediatric Abusive Head Trauma: A Systematic Review. Diagnostics, v. 11, n. 4, p. 734, 20 abr. 2021. DOI: https://doi.org/10.3390/diagnostics11040734.
MANAN, M. R. et al. A multispecialty approach to the identification and diagnosis of nonaccidental trauma in children. Cureus, v. 14, n. 7, 26 jul. 2022. DOI: https://doi.org/10.7759/cureus.27276.
MIAN, M. et al. Shaken Baby Syndrome: A Review. Fetal and Pediatric Pathology, v. 34, n. 3, p. 169–175, 23 jan. 2015. DOI: https://doi.org/10.3109/15513815.2014.999394.
MOREIRA, A. G. et al. SÍNDROME DO BEBÊ SACUDIDO: UMA ANÁLISE ABRANGENTE DA LITERATURA PARA COMPREENSÃO E PREVENÇÃO. REVISTA FOCO, [S. l.], v. 16, n. 10, p. e3241, 2023. DOI: https://doi.org/10.54751/revistafoco.v16n10-164.
MOSKWA, R. et al. Ophthalmological lesions in shaken baby syndrome: A retrospective analysis of 133 consecutive cases (1992–2018). Neurochirurgie, v. 68, n. 4, p. 367–372, jul. 2022. DOI: https://doi.org/10.1016/j.neuchi.2022.01.007.
MESSING-JÜNGER, M.; ALHOURANI, J. A suspected case of shaken baby syndrome—clinical management in Germany: a case-based overview. Child’s Nervous System, 2 nov. 2022. DOI: https://doi.org/10.1007/s00381-022-05723-0.
NADARASA, J. et al. Update on injury mechanisms in abusive head trauma - shaken baby syndrome. Pediatric Radiology, v. 44, n. S4, p. 565–570, dez. 2014. DOI: https://doi.org/10.1007/s00247-014-3168-9.
NUNES, A. J. & SALES, M. C. V. Violência contra crianças no cenário brasileiro. Temas Livres. Ciênc. saúde colet. 21 (3). Mar 2016. DOI: https://doi.org/10.1590/1413-81232015213.08182014.
ORUÇ, M. et al. Shaken baby syndrome resulting in death: a case series. The Turkish Journal of Pediatrics, v. 63, n. 1, p. 31, 2021. DOI: https://doi.org/10.24953/turkjped.2021.01.004.
PARKS, S. et al. Characteristics of non-fatal abusive head trauma among children in the USA, 2003–2008: application of the CDC operational case definition to national hospital inpatient data. Injury Prevention, v. 18, n. 6, p. 392–398, 10 fev. 2012. DOI: https://doi.org/10.1136/injuryprev-2011-040234.
REITH, W.; YILMAZ, U.; KRAUS, C. Shaken baby syndrome. Der Radiologe, v. 56, n. 5, p. 424–431, 1 maio 2016. DOI: https://doi.org/10.1007/s00117-016-0106-x.
SUNIEGA, E. A.; KRENEK, L.; STEWART, G. Child Abuse: Approach and Management. American Family Physician, v. 105, n. 5, p. 521–528, 1 maio 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35559624/.
VINCHON, M. Shaken baby syndrome: what certainty do we have? Child’s Nervous System, v. 33, n. 10, p. 1727–1733, 6 set. 2017. DOI: https://doi.org/10.1007/s00381-017-3517-8.
WITTSCHIEBER, D. et al. Understanding Subdural Collections in Pediatric Abusive Head Trauma. American Journal of Neuroradiology, 6 dez. 2018. DOI: https://pubmed.ncbi.nlm.nih.gov/30523144/.
WRIGHT, J. N. CNS Injuries in Abusive Head Trauma. American Journal of Roentgenology, v. 208, n. 5, p. 991–1001, maio 2017.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 João Paulo de Moura Fernandes, Luís Felipe Carvalho Pereira, Raul Felipe Oliveira Véras, Domingos Kauã Soares de Oliveira , Mateus Soares de Santana, Ramon Arraes Peixoto Saraiva, Francisco Carlos Ribeiro de Alencar, Patricia Rosane Leite de Figueiredo