Shaken baby syndrome without intracranial hemorrhage on initial computed tomography

Yair Morad, Isaac Avni, Louise Capra, Mary E. Case, Kenneth Feldman, Sylvia R. Kodsi, Debra Esernio-Jenssen, James L. Lukefahr, Alex V. Levin

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


We sought to describe the unique characteristics of children diagnosed with shaken baby syndrome (SBS) despite the absence of intracranial hemorrhage on cranial computerized tomography (CT) on hospital admission. Using an international e-mail-based listserv for professionals with an interest in child abuse, we identified and reviewed the charts of children hospitalized in different medical centers who were diagnosed with SBS although CT disclosed no signs of intracranial bleeding. Children with normal imaging were not included. Eight cases were identified. All children had cerebral edema in CT, which was severe on 7/8 cases (88%). All of these children had extensive retinal hemorrhage. The prognosis was poor; 5/8 infants died (63% mortality), and the rest had permanent neurologic damage. The diagnosis of SBS can be established even when CT at presentation does not demonstrate intracranial hemorrhage. We hypothesize that rapidly developing cerebral edema may cause increased intracranial pressure and tamponade that prevents the accumulation of intracranial blood. The prognosis in these cases is grave.

Original languageEnglish (US)
Pages (from-to)521-527
Number of pages7
JournalJournal of AAPOS
Issue number6
StatePublished - Dec 2004
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology
  • Pediatrics, Perinatology, and Child Health


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