Patient education: Abusive head injury in babies and children (The Basics)

What is an abusive head injury? — 

This injury can happen if a baby or child is hit in the head or shaken violently. It can cause serious damage to the brain or spine and can cause death. It is sometimes called "shaken baby syndrome."

What are the symptoms of an abusive head injury? — 

Symptoms can include:

●Not responding normally

●Acting fussy or constantly crying

●Swelling or bruising of the scalp

●Vomiting

●Seizures

●Trouble breathing

●Coma

A head injury that involves a broken skull or face bone can also cause:

●Bruising around the eyes or behind the ear

●Blood or clear fluid draining from the nose or ear

Symptoms can start right after the injury, or a few hours or even days later.

Many babies with abusive head injury do not have any obvious signs on their body. But some have other signs of abuse, like bruises or broken bones.

Is there a test for an abusive head injury? — 

If doctors suspect that a baby or child has an abusive head injury, they will do a physical exam and ask the parent or caregiver questions. They will also tests such as:

●Blood tests

●Imaging tests – These create pictures of the inside of the body. They include X-rays to look at the bones, and MRI or CT scans to look at the brain.

●Eye exam – This is to check for bleeding that can happen with a head injury.

The child will also be checked for other injuries.

How is an abusive head injury treated? — 

Treatment depends on how serious the injury is. The baby or child will often need to stay in the hospital for monitoring and support.

If a baby or child has an abusive head injury, doctors might want to examine other children in the home, too. If abuse has happened to 1 child, it's extremely important to make sure that any other children are safe.

Some babies and children with abusive head injuries do not survive. Others might recover partly, but often have long-term problems. These can include problems with thinking, learning, and development.

Can abusive head injuries be prevented? — 

Yes. Never shake or hit a baby or child.

Often, an abusive head injury happens when a baby cries a lot and the parent or caregiver gets frustrated. They might shake the baby to try to get them to stop crying. This can cause serious injury, even if the person wasn't trying to hurt the baby.

If you are a parent or caregiver and are having trouble coping, get support. If you are stressed, take breaks when you can. Put your baby down in a safe place, like their crib, until you are calm. Try to call a friend or relative if you need help. In the US, there is also a parent help line (1-800-422-4453) you can call any time.

What should I do if I think that someone might hurt a baby or child? — 

Get help right away. Resources include:

●The child's doctor or nurse

●ChildHelp USA (call 1-800-422-4453, or go to www.childhelphotline.org)

Call for emergency help (in the US and Canada, call 9-1-1) if you think that a child might be in immediate danger.

More on this topic

Patient education: Head injury in babies and children under 2 years (The Basics)
Patient education: Head injury in children and teens (The Basics)
Patient education: Moderate to severe traumatic brain injury (The Basics)
Patient education: Skull fractures (The Basics)

Patient education: Head injury in children and adolescents (Beyond the Basics)