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Donahue, MD, associate professor of ophthalmology, pediatrics and neurology at Vanderbilt University.
Cerebral damage caused by the impact of hitting an immobile object is also afeature of SBS—and in fact, the syndrome is characterized by symptoms that include brain swelling (see “Who, Where, What and Why”).
Why is the expertise of an ophthalmologist so sought after?
Because retinal hemorrhages are a telltale sign of SBS.
The trauma team, after examining the baby, calls in the attending ophthalmologist to confirm what they may suspect: shaken baby syndrome, the leading cause of death in child abuse cases in the United States.
The differential diagnosis for retinal hemorrhage in this age group includes leukemia, low blood platelets and clotting disorders, said Dr. History and clinical examination, along with the retinal hemorrhage, helps in making the SBS diagnosis.” Conversely, he said, the absence of retinal hemorrhages does not exclude the diagnosis of SBS.
Yet the presence of retinal hemorrhage in a suspicious situation makes the diagnosis very likely.
C., this spring, and one literally could hear a pin drop as she told her story. Eappen notes that she does not remember actually learning about SBS during her residency at Tufts University in the early 1990s. In fact, while there is more awareness about SBS today, it still represents a taboo subject, and oftentimes physicians would rather find some other explanation for retinal hemorrhage than child abuse.
However, this retinal hemorrhage is distinctive—not even severe motor vehicle accidents cause this type of bleeding.”Documentation Is Essential Dr.“The diagnosis is suspected by the pediatric, trauma or intensive care team.