RE: Research definitions of SBS

[Lane Strathearn <l.strathearn@xxxxxxxxxxxxxxxxx>]

Subdural OR subarachnoid OR retinal hemorrhage, rather than 'AND', would 
probably be more appropriate.  In the absence of other possible causes, I 
feel the diagnosis of SBS could still be sustained with only one of these 3 
factors present, without external evidence of trauma. Others may disagree. 
Otherwise I think this is an excellent categorization.

An article has just been published Pediatrics discussing infants with 
subdural hemorrhage but no other evidence of trauma. (PEDIATRICS Vol. 105 
No. 3 March 2000, pp. 549-553) 
 http://www.pediatrics.org/cgi/content/abstract/105/3/549
Dr Lane Strathearn
Paediatric Child Protection Registrar
Mater Children's Hospital
Brisbane, QLD, Australia. 4020

-----Original Message-----
From:	RozPal@aol.com [SMTP:RozPal@aol.com]
Sent:	1 March 2000 10:41
To:	Child Maltreatment Researchers
Cc:	Vincent.Palusci@spectrum-health.org
Subject:	Research definitions of SBS

Last December, I queried this group about how to define shaken baby 
syndrome
(SBS) for epidemiologic study.  Based your helpful responses, it seems
prudent to categorize SBS as a subset of abusive head trauma (AHT), thereby 
avoiding the controversy regarding impact.  I would appreciate everyone's
comments on this draft definition:

Case Definition:  All children ages 3 years or younger with evidence of
traumatic brain injury as identified by medical providers and/or autopsy 
with
traumatic subdural (SDH), subarachnoid (SAH) and retinal (RH) hemorrhage.
Other injuries which may be present include diffuse axonal injury (DAI),
parenchymal brain hemorrhage, spinal cord injury, skull or skeletal
fractures, and bruises.  Children with SDH and RH without history of
coagulopathy, metabolic disorder, motor vehicle collision or fall from
greater than four feet will be labeled as abusive head trauma (AHT). Of
these, those with no other evidence of head impact (soft tissue swelling,
scalp bruising or skull fracture) will be labeled as SBS.

Thanks, Vince Palusci
Michigan State University
vincent.palusci@spectrum-health.org