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Shaken baby syndrome (SBS) is a constellation of medical findings (often referred to as a "triad"): subdural hematoma, retinal bleeding, and brain swelling from which physicians, consistent with current medical understanding, infer child abuse caused by violent shaking. In a majority of cases there is no visible sign of external injury. Shaken baby syndrome is a subset of the broader form of child abuse termed ''abusive head trauma''. The Centers for Disease Control and Prevention identifies SBS as "an injury to the skull or intracranial contents of an infant or young child (< 5 years of age) due to inflicted blunt impact and/or violent shaking". The Crown Prosecution Service for England and Wales recommended in 2011 that the term ''shaken baby syndrome'' be avoided and the term ''Non Accidental Head Injury'', NAHI, be used instead.〔(Non Accidental Head Injury Cases (NAHI, formerly referred to as Shaken Baby Syndrome Prosecution Approach )〕 In 2009, the American Academy of Pediatrics recommended the use of the term ''Abusive Head Trauma'' to replace SBS.〔(Abusive Head Trauma: A New Name for Shaken Baby Syndrome )〕 SBS is often fatal and can cause severe brain damage, resulting in lifelong disability. Estimated death rates (mortality) among infants with SBS range from 15% to 38%; the median is 20%–25%. Up to half of deaths related to child abuse are reportedly due to shaken baby syndrome.〔}〕 Nonfatal consequences of SBS include varying degrees of visual impairment (including blindness), motor impairment (e.g. cerebral palsy) and cognitive impairments. ==Signs and symptoms== Characteristic injuries associated with SBS include retinal bleeds, multiple fractures of the long bones, and subdural hematomas (bleeding in the brain). These signs have evolved through the years as the accepted and recognized signs of child abuse and the shaken baby syndrome. Medical professionals strongly suspect shaking as the cause of injuries when a baby or small child presents with retinal bleed, fractures, soft tissue injuries or subdural hematoma, that cannot be explained by accidental trauma or other medical conditions.〔B.G.Brogdon,Tor Shwayder,Jamie Elifritz ''Child Abuse and its Mimics in Skin and Bone''〕 Retinal bleeds occur in around 85% of SBS cases; the type of retinal bleeds are particularly characteristic of this condition, making the finding very useful in establishing the diagnosis. While there are many other causes of retinal bleeds besides SBS, there are usually additional findings (ocular and/or systemic) which make the alternative diagnoses apparent. Fractures of the vertebrae, long bones, and ribs may also be associated with SBS. Dr. John Caffey reported in 1972 that metaphyseal avulsions (small fragments of bone had been torn off where the periosteum covering the bone and the cortical bone are tightly bound together) and "bones on both the proximal and distal sides of a single joint are affected, especially at the knee".〔 Additional effects of SBS are diffuse axonal injury, oxygen deprivation and swelling of the brain, which can raise pressure inside the skull and damage delicate brain tissue. Victims of SBS may display irritability, failure to thrive, alterations in eating patterns, lethargy, vomiting, seizures, bulging or tense fontanels (the soft spots on an infant's head), increased size of the head, altered breathing, and dilated pupils.〔(Types of brain injury: Shaken baby syndrome ). Brain Injury Association of America. Retrieved on September 24, 2007.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Shaken baby syndrome」の詳細全文を読む スポンサード リンク
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