CLINICAL CASE 7 Clinical Case 7/2 A young single mother startles awake and reali
ID: 123598 • Letter: C
Question
CLINICAL CASE 7 Clinical Case 7/2 A young single mother startles awake and realizes that her 2 month old infant has not awakened during the night for a feeding She rushes into infant's room and discovers that the baby is not breathing. She grabs her baby and shakes her violently and although the baby begins breathing again, she dies several hours later. 1. What do you think was the cause of the condition of not breathing? 2. What is the cause of death? 3. What is the pathology of this condition? 4. Describe what's happened with infant's brain? 5. Are you able to describe what we expect from autopsy?Explanation / Answer
1. CAUSES OF NOT BREATHING :
Sleep apnea is a possible life threatening disorder in which the breathing is obstructed frequently, If not treated at right time it could lead to serious complications.
In the above case given the possible cause of the condition of not breathing is sleep apnea.
2. CAUSE OF DEATH.
The mother was obviously scared and panicked which led her to violently shake her 2 months old infant which caused shaken baby syndrome. Shaken baby syndrome is a condition which occurs when the baby is shaken violently with or without the brain hitting the base of skull, the result of shaken baby syndrome is quite severe which include life long injuries or can also lead to death and in this case the cause of death was because of shaken baby syndrome as the baby did began to breath but passed away several hours later.
3. PATHOLOGY OF SHAKEN BABY SYNDROME :
The traumatic and non - traumatic injury seen in childrens are mostly caused by subdural bleeding which is situated in dura mater. The possible origin of sub dural hemorrhage ruptured intracranial aneurysm, the veins, tiny vessels present in dura mater. Contusions could be seen, while encepphalopathy is rarely used in shaken baby syndrome it could relate to irritability, seizures. cerebral swelling and hypoxic ischemic syndrome is also related to shaken baby syndrome.
4. PATHOPHYSIOLOGY OF SHAKEN BABY SYNDROME :
Due to violently shaking baby's head moved back and forth which led the brain hitting the roof of the skull which caused bruising, contusion, swelling, injury to the brain and hemorrhage. following the injury there is damage caused in the neuroaxis which is the axis of the central nervous system. The hemorhhage in the brain causes lots of blood loss which leads to hypoxia which is less oxygen supplied to the tissues or organs after which the cells or tissues are damages and swells causing cerebral oedema which increases the intra cranial pressure leading to perfusion and ischemia and finaly leads to death of the cells and tissues.
5. WHAT TO EXPECT FROM AUTOPSY REPORT :
1. while the causes could be different. An example of autopsy reports of shaken baby syndrome :-
a. Sometimes autopsy reports shows evidence of orbital tissue injury in shaken baby syndrome which are caused by excessive acceleration and deceleration force.