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Chapter 5 - Shaken Baby Syndrome

Abusive Head Trauma or Just a Type of Hydrocephalus?

from Section 2 - Medicine

Published online by Cambridge University Press:  07 June 2023

By
Knut Wester  and
Johan Wikström
Edited by
Keith A. Findley ,
Cyrille Rossant ,
Kana Sasakura ,
Leila Schneps ,
Waney Squier  and
Knut Wester
Keith A. Findley
Affiliation:
University of Wisconsin, Madison
Cyrille Rossant
Affiliation:
University College London
Kana Sasakura
Affiliation:
Konan University, Japan
Leila Schneps
Affiliation:
Sorbonne Université, Paris
Waney Squier
Affiliation:
John Radcliffe Hospital, Oxford
Knut Wester
Affiliation:
Universitetet i Bergen, Norway
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Summary

This chapter reviews epidemiological, clinical, and pathological aspects of benign external hydrocephalus, a medical condition that is a risk factor for development of subdural haematoma, and that frequently is mistaken for abusive head trauma (AHT). For infants, there are striking epidemiological similarities regarding gender and age between external hydrocephalus, subdural haematoma (SDH), and AHT/SBS. There is a marked male preponderance, in most infants the symptom debut occurs during the first 6 months, and prematurity appears to be more frequent. External hydrocephalus is known to predispose for development of SDH. Most infants with external hydrocephalus are born with a close-to-normal head circumference (HC) that starts to grow abnormally fast during the first postnatal months; most of these infants reach HC values compatible with hydrocephalus at the age of 2 to 3 months, the peak age at which AHT/SBS most often is diagnosed. Both in infantile SDH and AHT/SBS, the subdural fluid collections appear to be chronic, not acute as one would expect after a traumatic event. There are reasons to assume that external hydrocephalus often has been and will be misdiagnosed as AHT/SBS.

Keywords

benign external hydrocephalusbenign enlargement of the subarachnoid spaceshydrocephalussubdural haematomacerebrospinal fluidchronic subdural haematomas
Type
Chapter
Information
Shaken Baby Syndrome
Investigating the Abusive Head Trauma Controversy
 , pp. 85 - 104
Publisher: Cambridge University Press
Print publication year: 2023

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