Nonaccidental Trauma
Nonaccidental TBI is a special subset of TBI in children. It has been described as having a clinical triad of subdural hemorrhage, retinal hemorrhage, and encephalopathy, and is commonly associated with the history given, being incompatible with the severity of the injuries and the injuries being unwitnessed and inflicted by a solitary care provider (33).
Classically, this so- called shaken baby syndrome has been described as being due to shaking alone causing tearing of bridging veins and rotational forces causing diffuse brain injury. More recent studies have indicated that there is most likely an impact in addition to the shaking episode(s). Often, nonaccidental brain injury in young children is also accompanied by a delay in seeking medical attention, potentially resulting in a hypoxic component to the mechanism of injury (18,21,33).
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