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J Korean Child Neurol Soc. 1999 May;6(2):394-399. Korean. Case Report.
Park BS , Suh ES , Lee DH .
Department of Pediatrics, College of medicine, SoonChunHyang University, Seoul, Korea.

Head trauma is the most frequent cause of morbidity and death in abused children. The shaken impact syndrome results from both types of injury-impact and severe acceleration-deceleration effects associated with impact causing shearing forces on the bridging veins and parechyma. To make the diagnosis of shaken impact syndrome, the physician should be suspicious of every child under 1 year of age with non-accidental brain injury and altered consciousness. Certain clinical features such as retinal hemorrhage , complex, depressed, or diastatic fractures, and associated findings such as metaphyseal fracture and failure to thrive make the diagnosis of abuse more likely. Yet in the absence of these findings, the diagnosis of abuse rests upon discrepancies between the history given and the injury incurred. We experienced a case of shaken impact syndrome in a 13 month-old female who had subdural hemorrhage, fractures of skull and rib, and encephalomalacia, so we report and review the related literatures.

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