Symptoms of Shaken Baby Syndrome
There is often no obvious external evidence of injury or physical sign of violence, resulting in under diagnosis of this syndrome. Caregivers and even physicians who are not aware of what has happened to a baby may not detect injuries that are primarily internal, attributing the baby’s fussiness to an underlying cause such as a virus.

Symptoms vary and are caused by generalized brain swelling secondary to trauma. They may appear immediately after the shaking and usually reach a peak within 4-6 hours. The following signs and symptoms may indicate shaken baby syndrome:

Altered level of consciousness
Drowsiness accompanied by irritability
Coma
Convulsions or seizures
Dilated pupils that do not respond to light
Decreased appetite
Vomiting
Posture in which the head is bent back and the back arched
Breathing problems and irregularities
Abnormally slow and shallow respiration
Cardiac arrest
Death

Physical Findings upon Medical Examination
Retinal hemorrhages
Closed head injury bleeding
Lacerations
Contusions
Concussions
Bruises to the face, scalp, arms, abdomen or back
Soft tissue swelling that may indicate a fracture to the skull or other bones
Abdominal injuries
Chest injuries
Abnormally low blood pressure
Tense fontanel (soft spot)