Carl JG Huber's Journey - Shaken Baby Syndrome Survivor

I have here a link that describes the SBS but I also copied the most significant information here about SBS for all to see below: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Shaken-Baby-Syndrome

Shaken Baby Syndrome

Shaken Baby Syndrome (also known as Shaken Impact Syndrome) is a serious form of abuse inflicted upon a child. It usually occurs when a parent or other caregiver shakes a baby out of anger or frustration, often because the baby will not stop crying.

Babies have very weak neck muscles that cannot fully support their proportionately large heads. Severe shaking causes the baby’s head to move violently back and forth, resulting in serious and sometimes fatal brain injury. These forces are exaggerated if the shaking is interrupted by the baby’s head hitting a surface.

Shaking, with or without the sudden deceleration of the head when it impacts a surface, can cause the following:

Subdural hematoma, which is a collection of blood between the surface of the brain and the dura (the tough, fibrous outer membrane surrounding the brain.) This occurs when the veins that bridge from the brain to the dura are stretched beyond their elasticity, causing tears and bleeding.

Subarachnoid hemorrhage, which is bleeding between the arachnoid (web-like membrane surrounding the brain filled with spinal fluid) and the brain.

Direct trauma to the brain substance itself, caused when the brain strikes the inner surfaces of the skull.

Shearing off or breakage of nerve cell branches (axons) in the cortex and deeper structures of the brain caused by violent motion to the brain.

Further irreversible damage to the brain substance from the lack of oxygen if the child stops breathing during shaking.

Further damage to the brain cells when injured nerve cells release chemicals that add to oxygen deprivation to the brain.

Other injuries related to this abuse include:

Retinal hemorrhages ranging from a few scattered hemorrhages to extensive hemorrhages involving multiple layers of the retina.

Skull fractures resulting from impact when the baby is thrown against a hard or soft surface.

Fractures to other bones, including the ribs, collarbone and limbs; bruising to the face, head and entire body.

Prevalence and Incidence

This syndrome is primarily seen in children younger than age two, with the majority of cases occurring before the baby’s first birthday. The average victim is between three and eight months old. However, children up to age four have been victims of this abuse. The perpetrator of the abuse is most often the father, boyfriend of the mother, female babysitter or the mother. Parents experiencing stress because of environmental, social, biological or financial situations may be more prone to impulsive and violent behavior. Those involved with domestic violence and/or substance abuse may be at higher risk of inflicting this abuse.

The National Center on Shaken Baby Syndrome estimates that there are between 600 and 1400 cases in the U.S. a year. Because there is currently no reliable method of collecting these statistics, the true incidence is unknown. This syndrome is the most common cause of death and long-term disability in infants and young children who are victims of child abuse.

Symptoms and Signs

There is often no obvious external evidence of injury or physical sign of violence, resulting in under diagnosis of this syndrome. Caregivers and even physicians who are not aware of what has happened to a baby may not detect injuries that are primarily internal, attributing the baby’s fussiness to an underlying cause such as a virus.

Symptoms vary and are caused by generalized brain swelling secondary to trauma. They may appear immediately after the shaking and usually reach a peak within 4-6 hours. The following signs and symptoms may indicate shaken baby syndrome:

Altered level of consciousness

Drowsiness accompanied by irritability

Coma

Convulsions or seizures

Dilated pupils that do not respond to light

Decreased appetite

Vomiting

Posture in which the head is bent back and the back arched

Breathing problems and irregularities

Abnormally slow and shallow respiration

Cardiac arrest

Death

Physical Findings upon Medical Examination

Retinal hemorrhages

Closed head injury bleeding (subdural, epidural, subarachnoid, subgaleal)

Lacerations

Contusions

Concussions

Bruises to the face, scalp, arms, abdomen or back

Soft tissue swelling that may indicate a fracture to the skull or other bones

Abdominal injuries

Chest injuries

Abnormally low blood pressure

Tense fontanel (soft spot)

Suggested Diagnostic Studies

History

Optic fundus exam for retinal hemorrhages

Computed tomography scan (CT or CAT scan) of the head and abdomen

Magnetic resonance imaging (MRI) in select cases

Lumbar puncture with precautions

Skeletal survey

Nuclear scan

Drug screening

Routine blood samples

Prognosis

The prognosis for victims of shaken baby syndrome varies with the severity of injury but generally is poor. Many cases are fatal or lead to severe neurological deficits. Death is usually caused by uncontrollable increased intracranial pressure from cerebral edema, bleeding within the brain or tears in the brain tissue. However, even babies with injuries that appear to be mild may show developmental difficulties. Typically, surviving babies with this syndrome may develop any of the following disabilities:

Cerebral palsy

Paralysis

Vision loss or blindness

Mental retardation

Epilepsy

Seizures

Prevention

Shaken baby syndrome is completely preventable. Taking care of a baby can present challenges, especially for first-time parents. However, it is important to remember that it is never acceptable to shake, throw or hit a baby. The following tips may help prevent abuse:

Take a deep breath and count to 10

Take time out and let the baby cry alone

Call someone for emotional support

Call a pediatrician – there may be a medical reason why the baby is crying

Never leave a baby with a caregiver, friend or family member in whom there is not complete trust

Always check references carefully before entrusting a baby to a caregiver or daycare center