Document Detail

Long-term outcome in infants with the shaking-impact syndrome.
MedLine Citation:
PMID:  8988494     Owner:  NLM     Status:  MEDLINE    
Nonaccidental injury accounts for nearly one quarter of all hospital admissions for head injury in infancy, and is associated with significant morbidity and mortality. Long-term outcome in survivors, however, has been incompletely studied. In this series, 84 infants 2 years of age and younger with the shaking-impact syndrome consecutively admitted to a single hospital between 1978 and 1988 were identified. A questionnaire detailing current medical, developmental, and behavioral status was developed, and attempts were made to locate the 62 children surviving the acute injury. Family instability and strict confidentiality restrictions precluded locating the majority of children, but 14 children with demographic and injury characteristics similar to those of the overall group were contacted at an average of 9 years after injury. Seven children were severely disabled or vegetative, 2 were moderately disabled, and 5 had a good outcome. Of the latter group, 3 had repeated grades and/or required tutoring. Acute factors associated with poor outcome included unresponsiveness on admission, need for intubation, age less than 6 months, and bilateral or unilateral diffuse hypodensity on CT scan. All children with bilateral diffuse hypodensity and loss of gray-white differentiation on CT scan remained blind, retarded, nonverbal, and nonambulatory in spite of aggressive medical and surgical management. This study suggests that the majority of children surviving the shaking-impact syndrome suffer major permanent morbidity, and that acute factors predicting long-term outcome may help guide aggressiveness of care.
A C Duhaime; C Christian; E Moss; T Seidl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  24     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1997-04-02     Completed Date:  1997-04-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  292-8     Citation Subset:  IM    
Division of Neurosurgery, Children's Hospital of Philadelphia, PA 19104, USA.
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MeSH Terms
Battered Child Syndrome / diagnosis*,  mortality
Brain Damage, Chronic / diagnosis*,  mortality
Child, Preschool
Disability Evaluation
Follow-Up Studies
Head Injuries, Closed / diagnosis*,  mortality
Hematoma, Subdural / diagnosis,  mortality
Neurologic Examination
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome

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