Long-term outcome of the shaken baby syndrome and medicolegal consequences: a case report

Ann Phys Rehabil Med. 2009 Jun;52(5):436-47. doi: 10.1016/j.rehab.2009.03.001. Epub 2009 Apr 15.
[Article in English, French]

Abstract

Introduction: Studies of long-term outcome of the shaken baby syndrome (SBS) are scarce, but they usually indicate poor outcome.

Objectives: To describe long-term outcome of a child having sustained a SBS, to ascertain possible delayed sequelae and to discuss medicolegal issues.

Methods: We report a single case study of a child having sustained a SBS, illustrating the initial clinical features, the neurological, cognitive and behavioural outcomes as well as her social integration.

Results: The child sustained diffuse brain injuries, responsible for spastic right hemiplegia leading to secondary orthopaedic consequences, as well as severe cognitive impairment, worsening over time: the developmental quotient measured at 15 months of age was 55 and worsened as age increased. At 6 years and 8 months, the child's IQ had fallen to 40. Behavioural disorders became apparent only after several months and precluded any social integration. The child eventually had to be placed in a specialised education centre at age 5.

Discussion and conclusion: The SBS has a very poor outcome and major long-standing sequelae are frequent. Cognitive or behavioural sequelae can become apparent only after a long sign-free interval, due to increasing demands placed on the child during development. This case report confirms severity of early brain lesions and necessity for an extended follow-up by a multi-disciplinary team. From a medicolegal point of view, signaling the child to legal authorities allows protection of the child, but also conditions later compensation if sequelae compromise autonomy.

Publication types

  • Case Reports

MeSH terms

  • Brain Damage, Chronic / etiology*
  • Brain Damage, Chronic / rehabilitation
  • Caregivers / legislation & jurisprudence
  • Child Abuse / legislation & jurisprudence*
  • Child Behavior Disorders / etiology
  • Child, Institutionalized / legislation & jurisprudence*
  • Child, Institutionalized / psychology
  • Child, Preschool
  • Cognition Disorders / etiology
  • Compensation and Redress / legislation & jurisprudence*
  • Disease Progression
  • Epilepsies, Partial / drug therapy
  • Epilepsies, Partial / etiology
  • Follow-Up Studies
  • France
  • Hemiplegia / etiology
  • Humans
  • Infant
  • Institutionalization
  • Mandatory Reporting*
  • Prognosis
  • Retinal Hemorrhage / etiology
  • Shaken Baby Syndrome / complications*
  • Shaken Baby Syndrome / epidemiology