battered child syndrome


Summary: A clinical condition resulting from repeated physical and psychological injuries inflicted on a child by the parents or caregivers.

Top Publications

  1. Maxeiner H. [A postmortem view on "pure" subdural hemorrhages in infants and toddlers]. Klin Padiatr. 2002;214:30-6 pubmed
    ..This combination of findings is typically found in victims of massive events (car occupants in high-velocity crashes) and not compatible with a supposition of a minor fall causing this. ..
  2. Lee A. Bruises, blood coagulation tests and the battered child syndrome. Singapore Med J. 2008;49:445-9; quiz 450 pubmed
    ..Whenever necessary, the opinion of a haematologist should be sought in order to obtain an accurate diagnosis, which is essential for subsequent management and the prevention of further injury in the case of child abuse. ..
  3. Wirth I, Correns A, Hartwig S, Schmeling A, Schmidt S. [Homicide-suicide by a single gunshot to the head]. Arch Kriminol. 2008;221:17-27 pubmed
    ..After having administered a tranquilizer to the child, he held her head to his own and fired a contact shot to his right temple so that the bullet passed through both heads. ..
  4. Hartung B, Schaper J, Ritz Timme S, Strier U, Grass H. [Diagnostic imaging in cases of suspected child abuse--focus craniocerebral trauma divergent guidelines and resulting problems]. Arch Kriminol. 2011;228:39-45 pubmed
    ..From the authors' point of view it would be desirable to work out a common guideline taking into account paediatric radiological and medicolegal aspects. ..
  5. Christophe C, Guissard G, Sekhara T, Dan B, Avni E. [Diagnostic imaging in non-accidental brain injuries]. JBR-BTR. 2003;86:86-95 pubmed
    ..MRI, with its multiplanar capability and its sensitivity to cytotoxic edema and to degraded hemoglobin, is the modality of choice for detecting cerebral lesions in nonaccidental injury. ..
  6. Baeza Herrera C, García Cabello L, Domínguez Pérez S, Atzín Fuentes J, Rico Mejía E, Mora Hernández F. [Battered child syndrome. Surgical implications]. Cir Cir. 2003;71:427-33 pubmed
    ..We reviewed our experience with childhood trauma due to battered child syndrome in our hospital to learn the extent, circumstances, presentations, and consequences of this kind of ..
  7. Parulekar M, Elston J. Neuropathology of inflicted head injury in children. Brain. 2002;125:676-7; author reply 678 pubmed
  8. Case M, Graham M, Handy T, Jentzen J, Monteleone J. Position paper on fatal abusive head injuries in infants and young children. Am J Forensic Med Pathol. 2001;22:112-22 pubmed
    ..The pathologic findings of subdural hemorrhage, subarachnoid hemorrhage, and retinal hemorrhages are offered as "markers" to assist in the recognition of the presence of shearing brain injury in young children. ..
  9. Pascual Castroviejo I, Pascual Pascual S, Ruza Tarrio F, Viano J, Garcia Segura J. [Battered baby syndrome. Report of a case with severe sequelae]. Rev Neurol. 2001;32:532-5 pubmed
    ..Shaken-baby syndrome is not always associated with skull fracture nor is necessarily related with battered-child syndrome. ..

More Information


  1. Kivlin J, Simons K, Lazoritz S, Ruttum M. Shaken baby syndrome. Ophthalmology. 2000;107:1246-54 pubmed
    ..Nonophthalmologists' difficulty in detecting retinal hemorrhages may be an important limiting factor in identifying shaken babies so they can be protected from further abuse. ..
  2. Wootton Gorges S, Stein Wexler R, Walton J, Rosas A, Coulter K, Rogers K. Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants. Child Abuse Negl. 2008;32:659-63 pubmed publisher
    ..Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants...
  3. Hansen M, Weltzien A, Blum J, Botterill N, Rommens P. Complete distal humeral epiphyseal separation indicating a battered child syndrome: a case report. Arch Orthop Trauma Surg. 2008;128:967-72 pubmed
    ..g. birth injury or battered child syndrome. This is a case report of a 5-month-old female child with distal humeral epiphysiolysis...
  4. Ewing Cobbs L, Prasad M, Kramer L, Landry S. Inflicted traumatic brain injury: relationship of developmental outcome to severity of injury. Pediatr Neurosurg. 1999;31:251-8 pubmed
    ..Greater injury severity, as indicated by lower coma scale scores, longer periods of unconsciousness and the presence of edema/cerebral infarctions was associated with poorer outcomes in all domains. ..
  5. Swischuk L. Apnea in an infant: what should I look for?. Pediatr Emerg Care. 2007;23:345-7 pubmed
  6. Hong T, Reyes J, Moineddin R, Chiasson D, Berdon W, Babyn P. Value of postmortem thoracic CT over radiography in imaging of pediatric rib fractures. Pediatr Radiol. 2011;41:736-48 pubmed publisher
    ..However, the degree of improvement in sensitivity provided by CT might depend on observer experience. ..
  7. Scavarda D, Gabaudan C, Ughetto F, Lamy F, Imada V, Lena G, et al. Initial predictive factors of outcome in severe non-accidental head trauma in children. Childs Nerv Syst. 2010;26:1555-61 pubmed publisher
    ..88). PRISM II is a reliable and easy performing tool for assessing the prognosis of non-accidental cranial traumatism in young children. GCS and PTS, scores even simpler than PRISM II, showed good accuracy regarding survival prediction. ..
  8. Bohnert A, Roeder K, Ilgen M. Suicide attempts and overdoses among adults entering addictions treatment: comparing correlates in a U.S. National Study. Drug Alcohol Depend. 2011;119:106-12 pubmed publisher
    ..Individuals who have had a history of both may be a group with particularly poor psychological functioning as well as more severe drug-related problems. ..
  9. Ziegenhain U, Fegert J, Ostler T, Buchheim A. [Risk assessment of neglect and maltreatment in infants and toddlers. Chances of early preventive intervention]. Prax Kinderpsychol Kinderpsychiatr. 2007;56:410-28 pubmed
    ..However, these programs need to be adapted to delivery for specific risk groups. Overall an interdisciplinary approach with regard to the programs as well as to the training of the professionals has to be taken into account. ..
  10. Oransky I. Vincent J. Fontana. Lancet. 2005;366:710 pubmed
  11. Wrase B. [The role of the nurse in managing abused children]. Kinderkrankenschwester. 2004;23:249-51 pubmed
  12. Olivieri M, Kurnik K, Bidlingmaier C. Coagulation testing in the evaluation of suspected child abuse. Hamostaseologie. 2009;29:190-2 pubmed
    ..Clinician must know the limitations of these tests and keep in mind that an abnormal coagulation test does not exclude child abuse. Coagulation defects may be the consequence of child abuse and neglect or the two conditions may coexist. ..
  13. Geddes J, Whitwell H, Tasker R. Shaken baby syndrome. Br J Neurosurg. 2003;17:18 pubmed
  14. Morad Y, Kim Y, Armstrong D, Huyer D, Mian M, Levin A. Correlation between retinal abnormalities and intracranial abnormalities in the shaken baby syndrome. Am J Ophthalmol. 2002;134:354-9 pubmed
    ..The correlation in severity of both eye and head findings may suggest, however, that retinal abnormalities are the result of mechanical shaking forces. ..
  15. Labbe L, Perel Y, Maleville J, Taieb A. Erythema nodosum in children: a study of 27 patients. Pediatr Dermatol. 1996;13:447-50 pubmed
    ..Erythema nodosum is easily recognized clinically, but other subcutaneous lesions, especially nodular vasculitis and Schönlein-Henoch purpura, have to be excluded by pathologic study, in cases of atypical presentation or long duration. ..
  16. Newman R, Jalili M, Kolls B, Dietrich R. Factor XIII deficiency mistaken for battered child syndrome: case of "correct" test ordering negated by a commonly accepted qualitative test with limited negative predictive value. Am J Hematol. 2002;71:328-30 pubmed
    ..The commonly accepted approach of using only a qualitative test for the diagnosis of factor XIII deficiency is challenged by this case report. ..
  17. Gardner H. Correlation between retinal abnormalities and intracranial abnormalities in the shaken baby syndrome. Am J Ophthalmol. 2003;135:745; author reply 746 pubmed
  18. Uscinski R. Shaken Baby Syndrome: fundamental questions. Br J Neurosurg. 2002;16:217-9 pubmed
  19. Nuzzolese E, Lepore M, Montagna F, Marcario V, de Rosa S, Solarino B, et al. Child abuse and dental neglect: the dental team's role in identification and prevention. Int J Dent Hyg. 2009;7:96-101 pubmed publisher
    ..Emphasis is placed on an appropriate protocol to follow in the dental practice to best treat and protect children who may have suffered abuse, helping the team in the diagnosis and documentation. ..
  20. Dias M, Backstrom J, Falk M, Li V. Serial radiography in the infant shaken impact syndrome. Pediatr Neurosurg. 1998;29:77-85 pubmed
    ..These findings challenge some of the current dogma about the timing of radiographic changes following abuse and are important in timing the alleged abuse for legal purposes. ..
  21. Sorantin E, Lindbichler F. [Nontraumatic injury (battered child)]. Radiologe. 2002;42:210-6 pubmed
    ..After shaking the child is thrown away, with subsequent injuries. The aim of this article is the presentation of an overview regarding the radiology of the battered child. Typical examples will be shown. ..
  22. Sakamoto K. [Battered child syndrome and head trauma in infants]. No Shinkei Geka. 2002;30:461-76 pubmed
  23. Lancon J, Haines D, Parent A. Anatomy of the shaken baby syndrome. Anat Rec. 1998;253:13-8 pubmed
    ..The unique anatomic features of the infant's head and skeletal system, which account for the type and pattern of injuries observed in shaken baby syndrome, are emphasized in this article. ..
  24. Rohrer T. [Clinical assessment of suspected child physical abuse]. Radiologe. 2009;49:907-12 pubmed publisher
    ..Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. ..
  25. Marshall D, Brownstein S, Dorey M, Addison D, Carpenter B. The spectrum of postmortem ocular findings in victims of shaken baby syndrome. Can J Ophthalmol. 2001;36:377-83; discussion 383-4 pubmed
    ..The presence of any retinal or optic nerve sheath hemorrhage in an infant, in the absence of an appropriate explanation for these findings, should raise suspicion of child abuse. ..
  26. Clark B, Adams G, Luthert P. Retinal haemorrhages in infant head injury. Brain. 2002;125:677-8; author reply 678 pubmed
  27. Roche A, Fortin G, Labbé J, Brown J, Chadwick D. The work of Ambroise Tardieu: the first definitive description of child abuse. Child Abuse Negl. 2005;29:325-34 pubmed
    The first important monograph describing the battered child syndrome was written in 1860 by Ambroise Tardieu, a French forensic physician...
  28. Raj A. Correlation between retinal abnormalities and intracranial abnormalities in the shaken baby syndrome. Am J Ophthalmol. 2003;136:773; author reply 773 -4 pubmed
  29. Bode Jänisch S, Meyer Y, Schroeder G, Gunther D, Debertin A. [Clinical forensic examination findings and legal outcome in cases of suspected physical child abuse]. Arch Kriminol. 2011;228:73-81 pubmed
    ..Prison terms of 2 years and more were imposed only if the child suffered potentially or acute life-threatening injuries or if additional anogenital lesions were diagnosed indicating sexual child abuse. ..
  30. Papp Z. [Battered child syndrome mimicking acute appendicitis]. Orv Hetil. 2011;152:485-8 pubmed publisher
    The paper presents the case of a 15-year-old child suffering from battered child syndrome, who was operated on with the presumed diagnosis of acute appendicitis...
  31. Taieb A, Lasek Duriez A. [Atypical staphylococcal scalded skin syndrome: it could be battered child syndrome]. Rev Med Suisse. 2008;4:1107-8, 1110-1 pubmed
    ..staphylococcal scalded skin syndrome is presented and discussed within the clinical spectrum of the battered child syndrome. The authors underline the behavior of the parents in this setting, which can mislead the physician in ..
  32. Edelbauer M, Maurer K, Gassner I. Spinal subdural effusion - an additional sonographic sign of child abuse. Ultraschall Med. 2012;33:E339-E343 pubmed publisher
    ..Thus, spinal ultrasound should be part of the imaging examinations performed in infants with suspected abuse. ..
  33. Vitale M, Squires J, Zuckerbraun N, Berger R. Evaluation of the siblings of physically abused children: a comparison of child protective services caseworkers and child abuse physicians. Child Maltreat. 2010;15:144-51 pubmed publisher
    ..Although caseworkers and physicians disagree on certain issues related to the evaluation of CC, it is clear that limited resources should be directed at CC at highest risk for physical abuse. ..
  34. Kratz C, Schweiger B, Kemperdick H, Göbel U. Childhood multifocal skeletal non-Hodgkin lymphoma is a differential diagnosis of battered child syndrome. Pediatr Hematol Oncol. 2003;20:575-7 pubmed
    ..Radiographs revealed multiple fractures and epiphyseal and metaphyseal lesions highly significant for battered child syndrome. Six weeks later the authors diagnosed primary multifocal skeletal non-Hodgkin lymphoma...
  35. Hauser R, Gos T, Lipowski P, Kuczkowski J. [Retinal hemorrhages as a case for shaking trauma. Case report]. Arch Med Sadowej Kryminol. 2003;53:363-8 pubmed
    ..The necessity of postmortem investigation of the fundus and cranial nerves in fatal cases of shaking trauma is stressed. ..
  36. Levin A. Retinal hemorrhages: advances in understanding. Pediatr Clin North Am. 2009;56:333-44 pubmed publisher
    ..Detailed description of the hemorrhages and documentation are critical to diagnosis. Vitreoretinal traction appears to be the major causative factor. Outcome is largely dependent on brain and optic nerve injury. ..
  37. Castiglia P. Response to reader comments re: Castiglia P. (2001). Shaken baby syndrome. Journal of Pediatric Health Care, 15, 78-80. J Pediatr Health Care. 2002;16:46 pubmed
  38. Biousse V, Suh D, Newman N, Davis P, Mapstone T, Lambert S. Diffusion-weighted magnetic resonance imaging in Shaken Baby Syndrome. Am J Ophthalmol. 2002;133:249-55 pubmed
    ..In all patients with confirmed SBS, DWIMRI was abnormal and suggested diffuse or posterior cerebral ischemia, in addition to subdural hematomas in the pathogenesis of this disorder. ..
  39. Moran K. National Australian conference on shaken baby syndrome. Med J Aust. 2002;176:310-1 pubmed
  40. Clavert J, Gicquel P, Giacomelli M. [Osteogenesis imperfecta or child abuse]. Arch Pediatr. 2006;13:730-3 pubmed
  41. Corwin D, Keeshin B. Estimating present and future damages following child maltreatment. Child Adolesc Psychiatr Clin N Am. 2011;20:505-18 pubmed publisher
  42. Wegmann H, Orendi I, Singer G, Eberl R, Castellani C, Schalamon J, et al. The epidemiology of fractures in infants--Which accidents are preventable?. Injury. 2016;47:188-91 pubmed publisher
    ..Therefore, awareness campaigns and prevention strategies should focus on these mechanisms of accident in order to decrease the rate of fractures in infants. ..
  43. Kauppi A, Kumpulainen K, Karkola K, Vanamo T, Merikanto J. Maternal and paternal filicides: a retrospective review of filicides in Finland. J Am Acad Psychiatry Law. 2010;38:229-38 pubmed
    ..This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a discussion of the influence of diagnoses on decisions regarding criminal responsibility. ..
  44. Okłota M, Niemcunowicz Janica A, Załuski J, Ptaszynska Sarosiek I. [Non-accidental trauma in children. Case report]. Arch Med Sadowej Kryminol. 2009;59:255-8 pubmed
    ..This report presents an extremely interesting case of a young boy, in which a very detailed assessment of the files allowed for determining the circumstances of his sustaining injuries. ..
  45. Solarino M, De Filippi C, Solarino B. Radiological and forensic medicine aspects of traumatic injuries in child abuse. Radiol Med. 2009;114:1356-66 pubmed publisher
    ..This paper describes the radiologist's key role in identifying physical injuries due to child abuse, in accordance with current regulations. ..
  46. Latalski M, Skórzyńska H, Pacian A, Sokół M. Intensification of the phenomenon of violence in the family environment of teenagers. Ann Univ Mariae Curie Sklodowska Med. 2004;59:467-73 pubmed
    ..The research method was the survey estimating the Scale of Battered Child Syndrome (for teenagers and adults)...
  47. Bloch Bogusławska E, Wolsk E, Duzy J. [Child abuse syndrome]. Arch Med Sadowej Kryminol. 2004;54:155-61 pubmed
    ..A restrictive system of child protection can contribute to a significant decrease in the scale of this phenomenon. Scandinavian countries can be used as an example of such an approach. ..
  48. Glick S. [Child abuse--undiagnosed]. Harefuah. 2002;141:879-82, 931, 930 pubmed
    ..Each individual injury was treated separately, and the diagnosis of a battered child syndrome was not entertained...
  49. Lantz P. Diffusion-weighted MRI in shaken baby syndrome. Am J Ophthalmol. 2002;134:472; author reply 472-3 pubmed
  50. Grote A. [Traction retinal detachment, optic atrophy, apallic syndrome after shaking trauma in an infant]. Ophthalmologe. 2002;99:295-8 pubmed
    Ophthalmological examinations are important in children with suspected shaken baby and/or battered child syndrome. Retinal and epiretinal haemorrhages can indicate non-accidental injuries...
  51. D Lugoff M, Baker D. Case study: shaken baby syndrome--one disorder with two victims. Public Health Nurs. 1998;15:243-9 pubmed
  52. Jurczyk A, Wendorff J, Michalska A, Rybka K, Berent J. [Hypoxic-ischemic encephalopathy as a special form of head injury complication in battered child syndrome]. Arch Med Sadowej Kryminol. 2010;60:137-45 pubmed
    The battered child syndrome is increasingly more often described in literature. Head injuries experienced by battered children are the main cause of deaths and neurological complications...
  53. Maroteaux P, Le Merrer M. [Battered or brittle child?]. Arch Pediatr. 2003;10:679-80 pubmed