ISSN:
1432-0533
Keywords:
Key words Shaken baby syndrome
;
Shaken infant
;
Axonal injury
;
β-Amyloid precursor protein
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract We examined an autopsy series of 14 children with shaken baby syndrome (SBS) who lacked skull fracture. Evidence of axonal injury was sought using immunohistochemical stains for neurofilament, 68-kDa neurofilament and β-amyloid precursor protein (βAPP). βAPP-positive axons were present in the cerebral white matter of all cases of SBS but were also present in 6 of 7 children dying of non-traumatic hypoxic ischemic encephalopathy (HIE). Swollen axons were present in 11 of 14 cases of SBS and in 6 of 7 cases of HIE. βAPP-positive axons were present in both groups in the midbrain and medulla. The cervical spinal cord in SBS contained βAPP-positive axons in 7 of 11 cases; 5 of 7 contained swollen axons within the white matter tracts; in 2 immunoreactivity was localized to spinal nerve roots; in all 7 there was a predilection for staining at the glial head of the nerve root. Among cases of HIE, none showed abnormal axons or βAPP-positive reactivity in the cervical cord white matter. We conclude that cerebral axonal injury is common in SBS, and may be due in part to hypoxic/ischemic injury. Cervical cord injury is also common, and cannot be attributed to HIE. These findings corroborate suggestions that flexion-extension injury about the cervical spinal column may be important in the pathogenesis of SBS.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s004010050849
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