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Shaken baby syndrome (SBS), in its many guises (abusive head trauma, non-accidental injury, etc.) has been widely accepted and taught among paediatricians for more than 50 years. The central tenet of the hypothesis is that shaking can cause any or all of subdural haemorrhage (SDH), retinal haemorrhage (RH), and encephalopathy. These same pathologies are seen in normal newborn babies and infants after a range of insults, including trauma, and reflect the immature anatomy and pathophysiology of the infant brain and its covering membranes. Spinal damage is increasingly invoked to support the shaking diagnosis. This chapter examines the various brain, eye, and spinal pathologies claimed to be due to shaking, setting them in the context of the anatomy and specific vulnerabilities of the infant. We evaluate the empirical evidence that neuropathology can provide to support or refute these claims.
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