OUTCOME AND PROGNOSIS OF WHIPLASH SHAKEN INFANT SYNDROME - LATE CONSEQUENCES AFTER A SYMPTOM-FREE INTERVAL

Long-term follow-up five to 13 (mean seven years) of 13 cases of whipl ash-shaken-infant syndrome (WSIS) demonstrated long sign-free interval s. Full clinical appearance of neurological deficits takes four months for the interruption of brain growth, six to 12 months for lesions of the central nervous system long pathways, up to two years for epileps y, and three to six years for behavioural and neurospychological signs . In our series, WSIS ocurred at a mean postnatal age of 5.5 months an d caused intracranial, retinal and preretinal haemorrhages, intracrani al haematomas, oedema, contusional tears, and developmental disturbanc es interfering with the growth and differentiation of neural tissue an d with synaptic stabilisation. These mechanisms account for the long s ign-free interval that makes its impossible to formulate a precise and final neurological prognosis before the age of school entrance. Only one of our patients seems to have remained normal even several years a fter the shaking.