The whiplash shaken infant syndrome: what has been learned?

In 1974 John Caffey described a form of abuse in infants which he called "The Whiplash Shaken Infant Syndrome." This syndrome involves vigorous manual shaking of infants by the extremities or shoulders, with whiplash-induced intracranial and intraocular bleeding, but with no external signs of head trauma. This article reviews the literature on whiplash shaken infant syndrome since Caffey's original review. The bulk of this literature focuses on the use of cranial computed tomography in the diagnosis of head injury in infants. Many questions remain regarding the incidence of this syndrome, and the long term morbidity resulting from this type of injury in infants. Caffey's recommendations for routine, regular examinations of the ocular fundi in all babies, and for a massive public educational program on the hazards of shaking infants have yet to be carried out.