A syndrome of bleeding in the brain with retinopathy, but no external evidence of trauma, is known in infants. \nThere is an association with excessive crying and feeding difficulties in this condition. This has led to the hypothesis \nthat the injuries arise during violent shaking by an angry carer, causing the brain to rotate relative to the skull, \n(Shaken Baby Syndrome, SBS). \nAn alternative hypothesis, described here, (Dysphagic Infant Death Syndrome DIDS), is that injuries similar \nto those in SBS can result from venous hypertension during excessive coughing or vomiting. Such injuries occur \nââ?¬Å?naturallyââ?¬Â during paroxysms of coughing in Whooping Cough. High intra-abdominal pressure drives abdominal \nvenous blood up into the head, rupturing intracranial veins and capillaries. This results in subdural haemorrhages, \npetechiae in skin, and Valsalva Retinopathy in the eyes. This article considers when the excessive intra-abdominal \npressures are caused by violent vomiting and retching in pyloric stenosis.\nSome DIDS additional features, not occurring in SBS, may give warning of impending intracranial catastrophe. \nInfant skull suture growth rate depends on local stretch induced in the underlying Dura Mater. This will be increased \nduring venous hypertension, accelerating head growth rate analogous to the hydrocephalous mechanism. The \nprolonged inconsolable crying would be explained by Mallory-Weiss tears at the oesophageal-stomach junction \nduring repeated vomiting. Edema resulting from local leakage from over-distended cerebral veins and capillaries \nmay temporarily disable axon transmission, causing temporary loss of consciousness. Transient ââ?¬Å?spikingââ?¬Â fevers \nmay be seen in this condition if the temperature limiter center in the hypothalamus is temporarily disabled by such \nflooding. (Brainstem tissue is drained by the vertebral vein system whose tortuous nature smoothes out pressure \nspikes. This provides some protection of breathing and cardiac mechanisms which may remain normal.)\nIt is concluded that, unlike SBS, preventative measures should be possible for DIDS
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