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3 results

Shaken Baby Syndrome
  • Investigating the Abusive Head Trauma Controversy
  • Edited by Keith A. Findley, Cyrille Rossant, Kana Sasakura, Leila Schneps, Waney Squier, Knut Wester
  • Published online:
    07 June 2023
    Print publication:
    08 June 2023
  • Since the early 2000s, a growing body of scientific studies in neuropathology, neurology, neurosurgery, biomechanics, statistics, criminology and psychology has cast doubt on the forensic reliability of medical determinations of Shaken Baby Syndrome (SBS), more recently termed Abusive Head Trauma (AHT). Studies have increasingly documented that accidental short falls and a wide range of medical conditions, can cause the same symptoms and findings associated with this syndrome. Nevertheless, inaccurate diagnoses, unrealistic confidence expression, and wrongful convictions continue to this day. Bringing together contributions from a multidisciplinary expert panel of 32 professionals across 8 countries in 16 different specialties, this landmark book tackles the highly controversial topic of SBS, which lies at the intersection of medicine, science, and law. With comprehensive coverage across multiple disciplines, it explains the scientific evidence challenging SBS and advances efforts to evaluate how deaths and serious brain injuries in infants should be analysed and investigated.

  • Chapter 81 - Rasmussen encephalitis and related conditions

  • from Section 3 - Symptomatic epilepsy
  • Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
  • Book:
    The Causes of Epilepsy
    Published online:
    05 March 2012
    Print publication:
    14 April 2011, pp 573-578

  • Summary

    Head injuries may result from impact or shaking or a combination of these mechanisms, which act through translational or rotational forces. The classic presentation of non-accidental brain injury (NABI) in infants is the shaken baby syndrome (SBS), which is characterized by widespread parenchymal damage, diffuse axonal injury, subdural and/or subarachnoid hemorrhages, and retinal hemorrhages. Seizures occur more frequently in children with inflicted versus non-inflicted traumatic brain injury. Radiological imaging plays a crucial role in investigating NABI, in order to assess intracranial complications, guide clinical management, and provide documentary evidence for forensic investigation. Magnetic resonance imaging (MRI) detects hemorrhage in the sub acute stage (3-14 days) and demonstrates with high sensitivity early ischemic changes and diffuse axonal injury. Phenytoin has been considered the drug of choice for preventive treatment of early and late seizures while carbamazepine and valproate would be more suitable for the treatment of late seizures.

  • 10 - Plain Radiography in Child Abuse

  • from PART I - PLAIN RADIOGRAPHY
  • Edited by J. Christian Fox, University of California, Irvine
  • Book:
    Clinical Emergency Radiology
    Published online:
    07 December 2009
    Print publication:
    29 September 2008, pp 176-179

  • Summary

    Complete skeletal survey plain radiographs are essential in the evaluation of suspected child abuse, particularly in infants and toddlers. Extracranial abnormalities are detected in 30% to 70% of abused children with head injuries. Shaken baby syndrome is described as subdural hematoma, retinal hemorrhages, and long bone fractures with minimal external signs of trauma. Due to the close association of intracranial injuries with fractures in nonaccidental trauma, both CT of the head and complete bone survey radiographs should be minimal standard imaging in any suspected child abuse case. Fractures suggestive for nonaccidental trauma can be categorized based on specificity for abuse. Subtle injuries may be missed on initial acute skeletal survey. Delayed repeated skeletal radiographs may be needed. Negative skull radiographs as part of the skeletal survey do not obviate the need for obtaining CT of the brain to investigate for intracranial bleeding or injury in suspected abuse cases.