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JAMA Patient Page |

Inflicted Brain Injury in Children FREE

Janet M. Torpy, MD, Writer; Cassio Lynm, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2003;290(5):698. doi:10.1001/jama.290.5.698.
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Published online

Physical violence against children causes injury to both their bodies and their emotions. In some cases, these physical injuries are severe and can lead to permanent damage or even death. Because the brains of infants and children are fragile, any physical violence or even rough play can cause inflicted traumatic brain injury (brain damage due to violence caused by another person). The August 6, 2003, issue of JAMA includes an article about inflicted brain injuries in children.


One kind of inflicted traumatic brain injury is called the shaken baby syndrome. Infants who are shaken may not have any immediate sign of harm, but their brains may have severe damage from bruising, swelling, or internal bleeding. Brain injury is the leading cause of death in abused children.

Shaken baby syndrome is not usually a one-time event. Abuse of an infant or young child that causes this type of injury is often part of a pattern of abuse. Previous head injuries may be seen on special testing, such as a CT (computed tomography) scan or MRI (magnetic resonance image) of the brain.

Infants who have been shaken and are injured have a high mortality rate (chance of dying from the injury). Approximately 25% of shaken babies die from their traumatic brain injuries. The infants who do not die may have permanent, often severe damage to their vision, hearing, thinking, and learning capabilities. They may be blind, have seizures, have spasticity (tension and weakness of the muscles), have small heads with lack of growth of brain tissues, and may be severely mentally retarded.


  • Unexplained sleepiness or inability to awaken the child

  • Changes in crawling, walking, or speech patterns

  • Poor feeding or sucking

  • Irritability

  • Unexplained bruising or fractures in any part of the body

  • Coma


  • Early recognition of possible child abuse

  • Parenting support through classes, public resources, health care personnel, and family members

  • Stress reduction for parents

  • Education about age-appropriate behavior and healthy child growth and development

  • Careful evaluation of those outside the family who take care of children

Contact your doctor or a child-abuse hotline if you need help.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on intimate partner violence was published in the August 7, 2002, issue, and one on traumatic brain injury was published in the June 11, 2003, issue.

The JAMA Patient Page is a public service of JAMA . The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

Sources: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, American Academy of Pediatrics, National Institute of Child Health and Human Development, National Institute of Neurological Disorders and Stroke





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