Shaken Baby Syndrome

As a part of #MentalHealthAwarenessMonth, it is important to evaluate the impact mental health can have on our newest generation of children and the future of our world. 
This is the brain of an eight month old child. The parent of this baby admitted to forcefully shaking the child, which caused a fatal brain bleed; a subdural hematoma. Infants are particularly susceptible to intracranial injury as they have a relatively large, heavy head, weak neck musculature, immature brain myelination, and a soft brain with higher water content. Repetitive acceleration-deceleration forces cause shearing of the dural veins and with brain impact on the skull which can lead to seizures, increasing head circumference, budging / tense anterior fontanelle and altered mental status.
The shape of this brain is normal for most eight month old infants at this age. It is very soft, gelatinous, and is difficult to remove in one intact piece. What is not normal is the blood seen on the brain. That is due to trauma. In suspected shaken baby syndrome cases, the eyes are also removed. This is because the retina can pull away and the delicate vessels can tear due to the shaking – causing vitreoretinal traction and retinal hemorrhages. In the United States, injury accounts for most cases of fatal child abuse and is the leading cause of death in infants younger than one year old with abusive head trauma.

Biological parents who are young, single, uneducated, or have a history of child abuse are the most common perpetrators, meaning parents who were once victims of child abuse at the hands of their parent(s) or care-giver are more likely to abuse others one day. This phenomenon creates the classic cycle of ‘the abused becoming the abuser’ and is one example of how the mental health of our adult population is intimately linked to situations they were exposed to as children, including but not limited to physical; sexual; verbal; and psychological abuse; neglect and bullying.