Shaken baby syndrome: inflicted cerebral trauma. Committee on Child Abuse and Neglect, 1993-1994.

Physical abuse is the leading cause of serious head injury in infants. While physical abuse has in the past been a diagnosis of exclusion, data regarding the nature and frequency of head trauma consistently support a medical presumption of child abuse when a child younger than one year of age has intracranial injury. Shaken baby syndrome is a serious form of child maltreatment, most often involving infants younger than six months of age. It occurs commonly, yet it is frequently overlooked in its most subtle form and underdiagnosed in its most serious expression. Caretakers may misrepresent or have no knowledge of the cause of the brain injury. There is often an absence of externally visible injuries. Given the initial difficulty of identifying a shaken infant and the variability of the syndrome itself, the physician must be extremely vigilant regarding any brain trauma in infants and be familiar with the radiologic and clinical findings that support the diagnosis of the shaken baby syndrome.