The emerging shaken baby syndrome debate
Diagnoses of shaken baby syndrome are coming under scrutiny and a growing number of legal challenges, and some specialists say its primary symptoms can have many natural and accidental causes. The strong majority of medical professionals defend the reliability of the diagnoses, and say shaken baby syndrome can be definitively shown.
HISTORICAL DIAGNOSIS
Classic Symptoms
Most medical professionals agree this unique “triad of symptoms” are caused by trauma to a child’s head and brain by shaking and the accompanying rotation forces.
Subdural hemorrhage
Bleeding between the skull and membranes that cover the brain caused by the rupture of viens that bridge the two.
Brain swelling
Severe swelling and/or widespread lesions caused by the rupture of nerve fibers.
Retinal bleeding
Retinal bleeding, often accompanied by other eye damage, when seen in young children, is can be a sign of severe, whiplash shaking of the head.
other factors
In many shaken baby syndrome cases, there may be few outward visible signs of abuse.
Bruising, fractures
When triad symptoms are present, coupled with bodily bruises and bone fractures or breaks, the case of child abuse gets stronger.
EMERGING TRENDS
mitigating factors
Some medical specialists and lawyers say that the presence of the triad alone — or its individual components — is not enough to diagnose abuse and can often be explained in other ways. Some examples:
Other forces may be at work
Biomedical research shows that shaking alone does not generate enough force to produce the types of traumatic damage associated with shaken baby syndrome without causing major spinal injury. The head making contact with a hard or soft surface would.
Triad symptoms can result from natural diseases, previous injury
Murder charges were dropped against a Malden father after it was determined by medical specialists his 6-month-old son’s mother and grandmother had a rare genetic defect that made them more susceptible to ruptures of arteries or veins.
The state medical examiner’s office is reconsidering its ruling that 1-year-old Rehma Sabir of Cambridge died in 2013 from blunt force head injuries under the sole care of her nanny. Other evidence suggests the baby was sickly, had a bleeding disorder, and was healing from fracture wounds before her death.
HISTORICAL DIAGNOSIS
CLASSIC SYMPTOMS
Most medical professionals agree this unique “triad of symptoms” are caused by trauma to a child’s head and brain by shaking and the accompanying rotation forces.
Bleeding
Swelling
Subdural hemorrhage
Skull
Eyeball
Retina
Brain
1
2
3
Retinal bleeding
Retinal bleeding, often accompanied by other eye damage, when seen in young children, is can be a sign of severe, whiplash shaking of the head.
Subdural hemorrhage
Brain swelling
Bleeding between the skull and membranes that cover the brain caused by the rupture of viens that bridge the two.
Severe swelling and/or widespread lesions caused by the rupture of nerve fibers.
OTHER FACTORS
Bruises
Bruising, fractures
In many shaken baby sysdrome cases, there may be few outward visible signs of abuse.
When triad symptoms are present, coupled with bodily bruises and bone fractures or breaks, the case of child abuse gets stronger.
Fracture
EMERGING TRENDS
MITIGATING FACTORS
Some medicial specialists and lawyers say that the presence of the triad alone — or its individual components—is not enough to diagnose abuse and can often be explained in other ways. Some examples:
Other forces may be at work
Biomedical research shows that shaking alone does not generate enough force to produce the types of traumatic damage associated with shaken baby syndrome without causing major spinal injury. The head making contact with a hard or soft surface would.
Triad symptoms can result from natural diseases, previous injury
● Murder charges were dropped against a Malden father after it was determined by medical specialists his 6-month-old son’s mother and grandmother had a rare genetic defect that made them more susceptible to ruptures of arteries or veins.
● The state medical examiner’s office is reconsidering its ruling that 1-year-old Rehma Sabir of Cambridge died in 2013 from blunt force head injuries under the sole care of her nanny. Other evidence suggests the baby was sickly, had a bleeding disorder, and was healing from fracture wounds before her death.
HISTORICAL DIAGNOSIS
CLASSIC SYMPTOMS
OTHER FACTORS
Most medical professionals agree this unique “triad of symptoms” are caused by trauma to a child’s head and brain by shaking and the accompanying rotation forces.
In many shaken baby sysdrome cases, there may be few outward visible signs of abuse.
Bleeding
Subdural hemorrhage
Swelling
Skull
Eyeball
Retina
Fracture
Brain
Bruises
1
2
3
Retinal bleeding
Bruising, fractures
Retinal bleeding, often accompanied by other eye damage, when seen in young children, is can be a sign of severe, whiplash shaking of the head.
When triad symptoms are present, coupled with bodily bruises and bone fractures or breaks, the case of child abuse gets stronger.
Subdural hemorrhage
Brain swelling
Bleeding between the skull and membranes that cover the brain caused by the rupture of viens that bridge the two.
Severe swelling and/or widespread lesions caused by the rupture of nerve fibers.
EMERGING TRENDS
MITIGATING FACTORS
Some medicial specialists and lawyers say that the presence of the triad alone — or its individual components—is not enough to diagnose abuse and can often be explained in other ways. Some examples:
Other forces may be at work
Triad symptoms can result from natural diseases, previous injury
● Murder charges were dropped against a Malden father after it was determined by medical specialists his 6-month-old son’s mother and grandmother had a rare genetic defect that made them more susceptible to ruptures of arteries or veins.
● The state medical examiner’s office is reconsidering its ruling that 1-year-old Rehma Sabir of Cambridge died in 2013 from blunt force head injuries under the sole care of her nanny. Other evidence suggests the baby was sickly, had a bleeding disorder, and was healing from fracture wounds before her death.
Biomedical research shows that shaking alone does not generate enough force to produce the types of traumatic damage associated with shaken baby syndrome without causing major spinal injury. The head making contact with a hard or soft surface would.
SOURCES: Executive Summary of the Third National Conference on Shaken Baby Syndrome; “Shaken Baby Syndrome, Abusive Head Trauma, and Actual Innocence: Getting it Right,” Keith A. Findley, Patrick D. Barnes, David A. Moran, and Waney Squier
James Abundis / Globe Staff