Book contents
- Shaken Baby Syndrome
- Shaken Baby Syndrome
- Copyright page
- Dedication
- Contents
- Foreword
- About This Book
- Abbreviations
- Section 1 Prologue
- Section 2 Medicine
- Chapter 3 The Neuropathology of Shaken Baby Syndrome or Retino-Dural Haemorrhage of Infancy
- Chapter 4 The Importance of the Correlation between Radiology and Pathology in Shaken Baby Syndrome
- Chapter 5 Shaken Baby Syndrome
- Chapter 6 Shaken Baby Syndrome or Benign External Hydrocephalus
- Chapter 7 Are Some Cases of Sudden Infant Death Syndrome Incorrectly Diagnosed as Shaken Baby Syndrome?
- Chapter 8 Abusive Head Trauma
- Chapter 9 How I Became a Shaken Baby Syndrome Sceptic Paediatrician
- Section 3 Science
- Section 4 Law
- Section 5 International
- Section 6 Postface
- Appendix: Frequently Repeated Claims concerning Shaken Baby Syndrome
- Index
- Plate Section (PDF Only)
- References
Chapter 9 - How I Became a Shaken Baby Syndrome Sceptic Paediatrician
A Review of the Observations That Challenge the Existence of Shaken Baby Syndrome
from Section 2 - Medicine
Published online by Cambridge University Press: 07 June 2023
Book contents
- Shaken Baby Syndrome
- Shaken Baby Syndrome
- Copyright page
- Dedication
- Contents
- Foreword
- About This Book
- Abbreviations
- Section 1 Prologue
- Section 2 Medicine
- Chapter 3 The Neuropathology of Shaken Baby Syndrome or Retino-Dural Haemorrhage of Infancy
- Chapter 4 The Importance of the Correlation between Radiology and Pathology in Shaken Baby Syndrome
- Chapter 5 Shaken Baby Syndrome
- Chapter 6 Shaken Baby Syndrome or Benign External Hydrocephalus
- Chapter 7 Are Some Cases of Sudden Infant Death Syndrome Incorrectly Diagnosed as Shaken Baby Syndrome?
- Chapter 8 Abusive Head Trauma
- Chapter 9 How I Became a Shaken Baby Syndrome Sceptic Paediatrician
- Section 3 Science
- Section 4 Law
- Section 5 International
- Section 6 Postface
- Appendix: Frequently Repeated Claims concerning Shaken Baby Syndrome
- Index
- Plate Section (PDF Only)
- References
Summary
Shaken baby syndrome (SBS) is well accepted by child abuse paediatricians as an explanation for the triad when parents/caregivers can provide no explanation. There is mounting evidence on many fronts that SBS is not a valid or well-defined diagnosis, and that many cases of SBS have medical causes or are from accidental short falls. An incorrect SBS diagnosis has far-reaching implications for the alleged perpetrator, the family, the child, and society. The three most compelling reasons to doubt the existence of SBS are: multiple biomechanical studies show that shaking cannot produce nearly the forces needed to cause the triad; sutopsy studies of most infants with alleged SBS do not show microscopic findings of trauma, but rather of hypoxia; retinal hemorrhages - once thought pathognomonic of shaking through vitreous retraction - are seen wherever there is an abrupt and significant rise in intracranial pressure and are highly unlikely to be caused by shaking. This review also provides observations that question the existence of SBS and the underlying psychological reasons why SBS proponents do not accept the compelling evidence that puts the diagnosis of SBS into question.
Keywords
- Type
- Chapter
- Information
- Shaken Baby SyndromeInvestigating the Abusive Head Trauma Controversy, pp. 148 - 160Publisher: Cambridge University PressPrint publication year: 2023
References
Richards, PG, Bertocci, GE, Bonshek, RE et al. Shaken baby syndrome. Archives of Disease in Childhood. 2006;91(3):205–6.Google Scholar
Guthkelch, AN. Infantile subdural haematoma and its relationship to whiplash injuries. British Medical Journal. 1971;2(5759):430–1.Google Scholar
Caffey, J. On the theory and practice of shaking infants: Its potential residual effects of permanent brain damage and mental retardation. American Journal of Diseases of Children. 1972;124(2):161–9.Google Scholar
American Academy of Pediatrics. Shaken baby syndrome: Rotational cranial injuries. Technical report. Pediatrics. 2001;108(1):206–10.Google Scholar
Geddes, JF, Hackshaw, AK, Vowles, GH, Nickols, CD, Whitwell, HL. Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain. 2001;124 :1290–8.Google Scholar
Geddes, JF, Vowles, GH, Hackshaw, AK et al. Neuropathology of inflicted head injury in children. II. Microscopic brain injury in infants. Brain. 2001;124:1299–1306.Google Scholar
Geddes, JF, Tasker, RC, Hackshaw, AK et al. Dural haemorrhage in non-traumatic infant deaths: Does it explain the bleeding in ‘shaken baby syndrome?’ Neuropathology and Applied Neurobiology. 2003;29 :14–22.Google Scholar
Scheimberg, I, Cohen, MC, Zapata Vazquez, RE et al. Non-traumatic intradural and subdural haemorrhage and hypoxic ischaemic encephalopathy in fetuses, infants and children up to 3 years of age. Analysis of two audits of 636 cases from two referral centers in the United Kingdom. Pediatric Development Pathology. 2013;16:149–59.Google Scholar
Ommaya, A, Fass, F, Yarnell, P. Whiplash injury and brain damage. JAMA. 1968;204:75–9.Google Scholar
Löwenhielm, P. Strain tolerance of the Vv. Cerebri Sup. (bridging veins) calculated from head-on collision tests with cadavers.Zeitschrift für Rechtsmedizin. 1974;75(2):131–44.CrossRefGoogle Scholar
Depreitere, B, Van Lierde, C, Vander Sloten, J et al. Mechanics of acute subdural hematomas resulting from bridging vein rupture. Journal of Neurosurgery. 2006;104(6):950–6.Google Scholar
Duhaime, AC, Gennarelli, TA, Thibault, LE et al. The shaken baby syndrome: A clinical, pathological, and biomechanical study. Journal of Neurosurgery. 1987;66(3):409–15.CrossRefGoogle ScholarPubMed
Prange, MT, Coats, B, Duhaime, AC, Margulies, SS. Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants. Journal of Neurosurgery. 2003;99(1):143–50.Google Scholar
Lloyd, J, Willey, EN, Galaznik, JG, Lee III, WE, Luttner, SE. Biomechanical evaluation of head kinematics during infant shaking versus pediatric activities of daily living. Journal of Forensic Biomechanics. 2011;2(2):1–9.Google Scholar
Plunkett, J. Fatal pediatric head injuries caused by short-distance falls. American Journal of Forensic Medicine and Pathology. 2001;22(1):1–2.CrossRefGoogle ScholarPubMed
Atkinson, N, Van Rijn, RR, Starling, SP. Childhood falls with occipital impacts. Pediatric Emergency Care. 2018;34(12):837–41.CrossRefGoogle ScholarPubMed
Christian, CW, Block, R. Abusive head trauma in infants and children. Pediatrics. 2009;123(5):1409–11.Google Scholar
Thiblin, I, Andersson, J, Wester, K et al. Medical findings and symptoms in infants exposed to witnessed or admitted abusive shaking: A nationwide registry study. PLoS One. 2020;15(10):e0240182.Google Scholar
Finnie, JW, Blumbergs, PC, Manavis, J et al. Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome). Journal of Clinical Neuroscience. 2012;19(8):1159–64.Google Scholar
Muller, PJ, Deck, JH. Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension. Journal of Neurosurgery. 1974;41(2):160–6.Google Scholar
De Leeuw, M, Beuls, E, Jorens, PG, Parizel, P, Jacobs, W. The optic nerve sheath hemorrhage is a non-specific finding in cases of suspected child abuse. Journal of Forensic and Legal Medicine. 2015;36:43–8.Google Scholar
Lantz, PE, Adams, GG. Postmortem monocular indirect ophthalmoscopy. Journal of Forensic Science. 2005;50(6):JFS2005137-3.Google Scholar
Lantz, PE, Stanton, CA. Postmortem detection and evaluation of retinal hemorrhages. In 58th Annual Scientific Meeting of the American Academy of Forensic Sciences, 2006.Google Scholar
Personal communications with Dr Pat Lantz.Google Scholar
Thiblin, I, Andersson, J, Wester, K, Högberg, G, Högberg, U. Retinal haemorrhage in infants investigated for suspected maltreatment is strongly correlated with intracranial pathology. Acta Paediatrica. 2022;111(4):800–8.Google Scholar
Squier, W. Infant retinal haemorrhages correlate with chronic subdural haemorrhage, not shaking. Acta Paediatrica. 2022; 111(4):714–15.Google Scholar
Miller, R, Miller, ME. Overrepresentation of males in traumatic brain injury of infancy and in infants with macrocephaly: Further evidence that questions the existence of shaken baby syndrome. American Journal of Forensic Medicine and Pathology. 2010;31:165–73.Google Scholar
Miller, D, Barnes, P, Miller, M. The significance of macrocephaly or enlarging head circumference in infants with the triad: Further evidence of mimics of shaken baby syndrome. American Journal of Forensic Medicine and Pathology. 2015;36(2):111.Google Scholar
Krasnokutsky, MV. Cerebral venous thrombosis: A potential mimic of primary traumatic brain injury in infants. American Journal of Roentgenology. 2011;197(3):W503–W507.CrossRefGoogle ScholarPubMed
David, TJ. Non-accidental head injury: The evidence. Pediatric Radiology. 2008;38:370–7.Google Scholar
Leestma, JE. ‘Shaken baby syndrome’: Do confessions by alleged perpetrators validate the concept? Journal of American Physicians and Surgeons. 2006;11:14–26.Google Scholar
Hampton, JR, Harrison, MJ, Mitchell, JR, Prichard, JS, Seymour, C. Relative contributions of history-taking, physical examination, and laboratory investigation to diagnosis and management of medical outpatients. British Medical Journal. 1975;2(5969):486–9.Google Scholar
Plunkett, J. Recognizing abusive head trauma in children. Journal of the American Medical Association. 1999;282(15):1421–2.Google Scholar
Flaherty, EG, Stirling, J, Committee on Child Abuse and Neglect. The pedian’s role in child maltreatment prevention.Pediatrics. 2010;126(4):833–41.Google Scholar
Donohoe, M. Evidence-based medicine and shaken baby syndrome. Part 1: Literature review. 1966–1998. American Journal of Forensic Medicine and Pathology. 2003;24:239–42.CrossRefGoogle Scholar
Lynøe, N, Elinder, G, Hallberg, B et al. Insufficient evidence for ‘shaken baby syndrome’: A systematic review. Acta Paediatrica. 2017;106(7):1021–7.Google Scholar
Guthkelch, AN. Problems of infant retino-dural hemorrhage with minimal external injury. Houston Journal of Health Law and Policy. 2012;12:201–8.Google Scholar
Choudhary, AK, Servaes, S, Slovis, TL et al. Consensus statement on abusive head trauma in infants and young children. Pediatric Radiology. 2018;48(8):1048–65.CrossRefGoogle ScholarPubMed
Strouse, PJ. Child abuse: We have problems. Pediatric Radiology. 2016;46:587–90. https://doi.org/10.1007/s00247-016-3551-9.Google Scholar
Hymel, KP. Denying the abusive head trauma denialists their day in court, one step at a time. Pediatric Radiology. 2019;49(13):1710–11.Google Scholar
The backfire effect: Why facts don’t always change minds. https://effectiviology.com/backfire-effect-facts-dont-change-minds.Google Scholar
Gladwell, M. Talking to strangers: What we should know about the people we don’t know. Penguin UK, 2019.Google Scholar