Outcomes of infants
and children with
inflicted traumatic
brain injury
Kathi L Makaroff* MD, Research Instructor of Pediatrics;
Frank W Putnam MD, Director, Mayerson Center for Safe
and Healthy Children, Children’s Hospital Medical Center,
Cincinnati, OH, USA.
*Correspondence to first author at Mayerson Center for Safe
and Healthy Children, Children’s Hospital Medical Center,
SEB-5, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
E-mail: makok0@chmcc.org
Inflicted traumatic brain injury (ITBI) or shaken baby syn-
drome is recognized as a major cause of disability and death in
the pediatric population. Although advances have been made
in the recognition of the clinical, radiographic, and pathologi-
cal findings of ITBI, less is known about the long-term out-
comes of survivors. Health care providers recognize that these
infants and children frequently have poor outcomes. Although
an infant or child who sustains an ITBI may look well immedi-
ately after the trauma, that child may be left with serious and
permanent disabilities.
Here we review articles published since 1975 that discuss
the outcomes of infants and children with ITBI. Only articles
that had more specific outcome information than just sur-
vival were included in the survey. To find the articles, the
Medline bibliographic database was searched with the fol-
lowing search terms: shaken baby syndrome, head injury,
traumatic brain injury, impact injury, shaking impact syn-
drome, non-accidental injury, child abuse, inflicted injury,
follow-up, outcome, neurological outcome, and vision. A
bibliography search of articles was also used.
Data extracted from the articles included: the number of
patients studied, the patient’s age at injury, the interval to out-
come measurement (or age of patient at outcome measure-
ment), the definition and qualification of injury, the outcome
measures, and patient outcomes. Patients were categorized
into outcome groups when possible (Table I), but ophthalmo-
logic outcomes were not categorized into groups (Table II).
Outcome