Children are more likely to die if they shake vigorously

Children are very susceptible to severe brain damage, even death if adults have strong care or play movements that dramatically change the young posture such as lifting up, lifting the child up and down, shoving, shaking, shaking .

According to many studies in the world, among children with brain injury, up to 33% is due to shaking syndrome. About one third of them die from severe brain damage, while the rest have acute or subacute clinical manifestations. There are children without symptoms, but severe neurological sequelae throughout their lives.

The shaking syndrome has been known since the early 70s of the last century, warned by image diagnosis doctor Caffey.

Children are more likely to bleed from their brain if they are strongly shaken.(Photo: BBC)

When caring for or playing with children, there are strong movements that change a child's posture quickly and abruptly, such as: the child is lying on the ground, lifting the child up and down and pushing, pushing, support, shake or rotate children continuously. Among these movements, constant shaking or twirling is the most dangerous, because it can cause nerve fibers to break, which is a very serious brain damage.

Most cases of shaking syndrome occur in children under 2 years of age, between 6 weeks and 4 months of age have the highest incidence.

The head of the baby has a quite large weight and volume compared to the body, the muscle mass of the neck is too weak to support the head so when shaking, inertia and acceleration of the big head, it is easy to cause brain injury. Young brain cells with lots of water, loose brain organization, incomplete myelin axon, so that when shaking, it is easy to break nerve axons or edify brain tissue.

The amount of fluid in the subarachnoid cavity is much higher, the number of cerebral vessels in children is greater in adults, especially the subarachnoid blood vessels, the structure of the vascular wall is not as strong as that of adults. Therefore, brain tissue and blood vessels are very vulnerable to shaking.

Cerebral bleeding is the most common lesion, which can occur anywhere in the skull, but is primarily a subarachnoid bleeding. About one-third of blood flow in large numbers, causing cerebral edema and cerebral hypoxia, increased intracranial pressure, pinched into nerve centers. Clinical manifestations are often very severe with acute changes, children with symptoms such as irritation, vomiting, seizures, lethargy, lethargy or paralysis, dyspnea, bulging, big head, copper death . can lead to death.

About two-thirds of the blood flows in a small amount, or flows slowly, so that the young brain has time to adapt, there is no clinical or vague, non-specific symptoms such as poor eating, slow growth, weight loss. mental development and movement, decreased vision or loss, epilepsy .

How to diagnose?

Previously, only relying on clinical symptoms, cerebrospinal fluid, electroencephalography, the diagnosis of cerebral bleeding was very difficult, many cases were not detected. Today, thanks to the imaging diagnostic tools such as ultrasound through fontanel, computerized tomography, magnetic resonance imaging, the doctor will detect lesions such as fluid capsules, brain atrophy, calcification of brain tissue. .

Nerve axon damage in vibration syndrome is often very severe, difficult to diagnose, most deaths, if survived, leave a severe neurological sequelae throughout life. Image diagnosis methods such as ultrasound through the fontanel, computerized tomography, magnetic resonance imaging cannot detect nerve axon damage, in addition to signs suggesting brain edema.

Some other forms of injury may occur such as retinal hemorrhage causing decreased vision, disordered hindquarters and damage to the medullary bone that causes weakness or paralysis of the limbs, even causing sudden death from cardiac arrest. .

The finding was difficult, the treatment was more difficult. Depending on the morphology and extent of the lesion in the acute phase, surgery or resuscitation against the cerebral edema may be required to save a young life.

Doctor Tran Van Phuc