Materiały źródłowe

• #1 Shaken baby syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shaken-baby-syndrome/symptoms-causes/syc-20366619

  Shaken baby syndrome is a serious brain injury that results from forcefully shaking an infant or a toddler. […] Seek help right away if you suspect your child has been injured by violent shaking. Call 911 or your local emergency number or take your child to the nearest emergency room. Getting medical care right away may save your child’s life or prevent serious health problems. […] Healthcare professionals are legally required to report all suspected cases of child abuse to state authorities. […] Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a baby or toddler due to frustration or anger. […] Shaken baby syndrome is not caused by bouncing a child on your knee or minor falls. […] Children who survive shaken baby syndrome may require lifelong medical care for conditions such as: […] Diagnosis treatment.

• #2 Shaken baby syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Shaken_baby_syndrome

  CT scanning and magnetic resonance imaging are used to diagnose the condition. […] The terms non-accidental head injury or inflicted traumatic brain injury have been used in place of „abusive head trauma” or „SBS”. […] The US Centers for Disease Control and Prevention identifies SBS as „an injury to the skull or intracranial contents of an infant or young child ( 5 years of age) due to inflicted blunt impact and/or violent shaking”. […] In 2009, the American Academy of Pediatrics recommended the use of the term abusive head trauma (AHT) to replace SBS, in part to differentiate injuries arising solely from shaking and injuries arising from shaking as well as trauma to the head. […] AHT is a more internationally-recognized term, as it encompasses various mechanisms of injury, such as impact alone or impact due to shaking. […] Conditions that are often excluded by clinicians include hydrocephalus, sudden infant death syndrome (SIDS), seizure disorders, and infectious or congenital diseases like meningitis and metabolic disorders.

• #2 Shaken baby syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Shaken_baby_syndrome

  Diagnosis can be difficult as symptoms may be nonspecific. […] A CT scan of the head is typically recommended if a concern is present. […] If there are concerning findings on the CT scan, a full work-up for child abuse often occurs, including an eye exam and skeletal survey. […] Diagnosis is generally characterized by a triad of findings: retinal hemorrhage, encephalopathy, and subdural hematoma. […] A 2023 review concluded „research has shown the triad is not sufficient to infer shaking or abuse and the shaking hypothesis does not meet the standards of evidence based medicine”. […] Examination by an experienced ophthalmologist is critical in diagnosing shaken baby syndrome, as particular forms of ocular bleeding are strongly associated with AHT. […] Magnetic resonance imaging may also depict retinal hemorrhaging but is much less sensitive than an eye exam.

• #3 National Center on Shaken Baby Syndrome – Medical Consensus

  https://www.dontshake.org/learn-more/item/89-medical-consensus

  In May 2018, The Society for Pediatric Radiology (SPR), European Society of Paediatric Radiology (ESPR), American Society of Pediatric Neuroradiology (ASPNR), American Academy of Pediatrics (AAP), European Society of Neuroradiology (ESNR), American Professional Society on the Abuse of Children (APSAC), Swedish Paediatric Society, Norwegian Pediatric Association and Japanese Pediatric Society published a joint consensus statement on abusive head trauma/shaken baby syndrome. This is the most comprehensive and complete consensus statement published to date. The statement is published in Pediatric Radiology. […] AAP continues to affirm the dangers and harms of shaking infants, continues to embrace the shaken baby syndrome diagnosis as a valid subset of the AHT diagnosis, and encourages pediatric practitioners to educate community stakeholders when necessary.

• #3 National Center on Shaken Baby Syndrome – Medical Consensus

  https://www.dontshake.org/learn-more/item/89-medical-consensus

  A child suspected of abusive head injury is referred by paediatricians to an ophthalmologist for evaluation. The incidence of abusive head injury in children is highest in infancy and less frequently seen in children over 3 years of age. Retinal haemorrhages have a high positive predictive rate for abusive head injury. […] SBS, a form of non-accidental trauma, occurs when babies are shaken. This shaking damages the brain and eyes and can lead to lifelong consequences including death. When there is suspected abuse an eye examination is performed to look for injury. The eye examination is only one aspect of an SBS diagnosis. An evaluation includes multiple experts who examine the child’s brain, bones, and environment. Alternate explanations for injuries are looked into and tested prior to diagnosing SBS.

• #4 Azthena logo with the word Azthena

  https://www.news-medical.net/health/How-is-Shaken-Baby-Syndrome-Diagnosed.aspx

  Shaken baby syndrome (SBS) is a condition that is recognized in infants who have been violently shaken. It is the leading cause of death in abused infants. Brain cells are easily destroyed by the forces generated during the shaking. […] Severe symptoms are recognized immediately following the trauma. Retinal and subdural hemorrhages are the clinical hallmarks of SBS. […] Affected infants may have an increased head circumference and bulging soft spots on the head. In addition to this, they may have bruises, signs of the abuse and thus, a team of various healthcare professionals are needed for definitive diagnosis. […] It is not an easy task to detect or diagnose victims with SBS. However, SBS should be considered in any child or infant who collapses without an obvious cause. […] Neuroimaging is a key technique in terms of diagnosing SBS. Intracranial pathologies such as cerebral edema and subdural and subarachnoid hemorrhage may be identified with the help of CT scans.

• #4 Azthena logo with the word Azthena

  https://www.news-medical.net/health/How-is-Shaken-Baby-Syndrome-Diagnosed.aspx

  Approximately 9 in every 10 infants with SBS will have retinal hemorrhages that are diffuse, bilateral, and multilayered. […] Thus, ophthalmological examination is required to support a definitive diagnosis. Other laboratory tests such as a complete blood count, biochemical panels, cerebrospinal fluid examination, and urine cultures are all supportive when diagnosing SBS.

• #5 Shaken Baby Syndrome: A Diagnosis Challenged | The Child Cases | FRONTLINE | PBS

  http://www.pbs.org/wgbh/pages/frontline/the-child-cases/shaken-baby-syndrome/

  Shaken baby syndrome was a fairly accepted diagnosis through the 1980s and ’90s — an excellent primer on its history and controversy can be found in Emily Bazelon’s February 2011 New York Times Magazine article on the subject. While some forensic pathologists no longer consider shaken baby syndrome when doing autopsies — one, Dr. Jon Thogmartin, told us that his colleagues are backing away from it „in droves” — there is still fierce disagreement about the subject in the forensic, medical and legal communities. […] Defenders of the diagnosis say that the „triad” of symptoms — subdural and retinal hemorrhaging and swelling around the brain — more often than not points to abuse from shaking. […] Statistics show that more than 1,000 children are diagnosed with shaken-baby syndrome per year, and anywhere between 100-200 of these cases result in a criminal trial. In the course of reporting The Child Cases with NPR and ProPublica, we found several instances of people being convicted of shaking a baby to death, only to be exonerated after new evidence came to light.

• #6

  https://www.fox26houston.com/news/critics-parents-question-diagnosis-of-shaken-baby-syndrome

  A growing number of medical experts believe the diagnosis of shaken baby syndrome is being misdiagnosed in too many cases that often end up breaking up innocent families. […] Doctor’s concluded he was the victim of abusive head trauma (AHT), a new term for shaken baby syndrome (SBS). […] Since researchers first identified the phenomenon with studies on monkeys, there have been three symptoms used to diagnose shaken baby syndrome: a subdural hematoma, when blood fills the space between the brain and skull; cerebral edema which is swelling of the brain; and retinal hemorrhage, bleeding in the back of the eye. […] Ophoven is part of a chorus of expert witnesses now convinced SBS is being misdiagnosed by pediatricians, when there is no other sign of child abuse. […] All three say there are a variety of causes for those same three symptoms, including viral and bacterial infections and even a premature birth or vitamin deficiency.

• #7 Has a 'shaken baby’ always been shaken? | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2018/09/kronikk/has-shaken-baby-always-been-shaken

  There is cause for concern over uncertainty associated with the diagnosis of shaken baby syndrome. We must have scientifically valid evidence in such cases. […] However, I am uncertain as to whether the medical evidence currently considered by experts to constitute proof of shaking is of sufficient scientific quality to be used as judicial proof that shaking has in fact occurred, and consequently that there is 'guilt beyond reasonable doubt’. […] The triad consists of three clinical findings: subdural haematoma, extensive retinal haemorrhage and encephalopathy. […] If the triad is to be considered to constitute judicial proof, then the publications claiming to show a definite causal link between these findings and shaking must be of such good scientific quality that there can be no doubt about the strength of the evidence.

• #8 Child abuse: Evaluation and diagnosis of abusive head trauma in infants and children – UpToDate

  https://www.uptodate.com/contents/child-abuse-evaluation-and-diagnosis-of-abusive-head-trauma-in-infants-and-children

  Child abuse: Evaluation and diagnosis of abusive head trauma in infants and children […] The evaluation and diagnosis of abusive head injury in infants and children will be presented here. […] Abusive head injury is the most common cause of death and long-term disability resulting from physical child abuse. […] As a result, as many as 30 percent of children with abusive head injury may be misdiagnosed at the initial evaluation. […] Identification of abusive head injury can be lifesaving. […] The constellation of injuries associated with this mechanism has been referred to as „shaken baby syndrome” (SBS), „infant whiplash syndrome,” „shaken/impact syndrome,” or more simply as „inflicted or abusive head trauma.” […] The significance of the diagnosis (with regards to morbidity, child protection, and criminal prosecution) may be similar, regardless of whether injury resulted from direct blows or from shaking. […] For this reason, the term „abusive head injury” is preferred to „shaken baby syndrome” to permit consideration of multiple mechanisms of injury in any child.

• #9 Shaken baby syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shaken-baby-syndrome/diagnosis-treatment/drc-20366641

  A child who’s been forcefully shaken needs to be examined by many different medical specialists, as well as an expert in child abuse. […] The healthcare professionals examine the child and ask questions about the child’s medical history. Various tests may be needed to detect injuries, including: […] Skeletal survey. Several X-rays of the bones may be used to determine whether fractures are accidental or intentional. X-rays may be taken of the arms, hands, legs, feet, spine, ribs and skull. Such testing also can help find previous fractures. […] Eye exam. An eye exam can reveal bleeding in the eye and other eye injuries. […] Blood tests. Some metabolic and genetic conditions, as well as bleeding and clotting conditions, can cause symptoms similar to those of shaken baby syndrome. Blood tests can help rule out some of these conditions.

• #9 Shaken baby syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/shaken-baby-syndrome/diagnosis-treatment/drc-20366641

  MRI scan. MRI uses a powerful magnetic field and radio waves to create detailed images of a child’s brain and spine. It can show brain bruising, bleeding and signs of decreased oxygen. Because an MRI is difficult to perform on a child who’s unstable, it’s usually done 2 to 3 days after the injury. […] CT scan. A CT scan uses X-ray images to provide cross-sectional images of the body. A scan of the brain can help detect injuries that need urgent treatment. A scan of the abdomen also may be done to determine if there are other injuries. […] Depending on the extent of the injuries, the baby may need to be monitored in a pediatric intensive care unit.

• #10 7. Assessment and Diagnosis of SBS/AHT | ATrain Education

  https://www.atrainceu.com/content/7-assessment-and-diagnosis-sbsaht

  A diagnosis begins with the chief complaint and the presenting symptoms. This is followed by a complete medical history, a detailed trauma history, and a complete physical examination. […] More than any other diagnosis, a clinician who suspects child abuse must consider inconsistencies, which may include a history that is: Absent in the presence of severe injuries, Inconsistent with the known developmental capabilities of the child, Pathophysiologically inconsistent with the injuries, Inconsistent with clinical studies and statistical information on subdural hematomas and retinal hemorrhages (Narang, 2013).

• #10 7. Assessment and Diagnosis of SBS/AHT | ATrain Education

  https://www.atrainceu.com/content/7-assessment-and-diagnosis-sbsaht

  For reasons inexplicable to many physicians, and unbeknownst to many others, the diagnosis of abusive head trauma/shaken baby syndrome remains a lightning rod for controversy. […] Although shaken baby syndrome/abusive head trauma is known by many names, and disagreement continues over its exact causes, abusive head trauma has long been recognized as a clinically valid medical diagnosis (Narang, 2011). […] During the initial interview, healthcare providers should be aware of a possible SBS/AHT injury in any infant or young child who presents with a history that is not plausible or consistent with the presenting signs and symptoms. […] In addition to a thorough history and physical exam, ophthalmologic examination, computerized tomography, magnetic resonance imaging, and skeletal surveys may be used in the diagnosis of SBS/AHT.

• #11 Shaken Baby Syndrome (Abusive Head Trauma): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13779-shaken-baby-syndrome

  Shaken baby syndrome is a type of brain injury that occurs when a baby or toddler is shaken violently. This can cause swelling, bruising and bleeding in and around their brain. […] Diagnosing shaken baby syndrome may be difficult for several reasons: Healthcare providers dont always get the truth about whether or not shaking was involved in an infants injury. Babies and very small children cant tell healthcare providers what happened or what hurts. Many symptoms of shaken baby syndrome (such as irritability, vomiting or lethargy) are also common in other conditions, such as viral infections. […] Therefore, a healthcare provider will use visual clues and tests to diagnose the condition and determine how severe it is. Theyll check your babys eyes for bleeding, look for marks on their skull, arms or legs, and check for bruises around their neck and chest. […] Healthcare providers may use certain imaging tests to diagnose shaken baby syndrome. These tests can show signs of swelling or bleeding in your babys brain and also show skull or rib fractures. These tests may include: X-rays, Computed tomography (CT) scans, Magnetic resonance imaging (MRI) scans.

• #12 National Center on Shaken Baby Syndrome – The Basics: What other Medical Conditions look like Abusive Head Trauma?

  https://dontshake.org/learn-more/item/284-the-basics-what-other-medical-conditions-look-like-abusive-head-trauma

  A CT (computed tomography) scan is an X-ray technique that produces a detailed cross-section of tissue structure. An MRI (magnetic resonance imaging) is medical imagining that gives pictures of organs and different structures of the body which gives different information about the body than can be seen with an X-ray, ultrasound, or CT scan. […] A CT scan gives sufficient resolution and detail to allow a physician to evaluate an acute brain injury in an abused child. MRI scans are used several days to a week after an injury to better diagnose the types of injuries to the brain and show changes in the brain tissue. Most skull fractures can be best shown with an X-ray. […] Clinical history, physiologic data, and imaging are the three (3) sources physicians use to establish the timing of head injuries.

• #13 Shaken Baby Syndrome: Signs and Symptoms

  https://www.webmd.com/parenting/baby/shaken-baby-syndrome

  Shaken Baby Syndrome Diagnosis […] Because shaken baby syndrome can affect so many parts of a child’s health, there may be more than one doctor or specialist involved in the diagnosis. Depending on the child’s level of injury, the tests may be done in doctor’s offices or a pediatric intensive care unit. […] To check the brain, doctors may use a CT scan to look for injuries that need attention right away. MRI scans also show doctors detailed areas of the brain. […] X-rays of other body parts, like the arms, legs, spine, and skull, show fractures and whether they were created by force or accident. Doctors might also use a full body scan in babies known as a „skeletal survey.” […] To check for eye injuries and bleeding, an eye specialist may do an eye exam. […] Some disorders can mimic the symptoms of shaken baby syndrome. To rule those out, doctors may order blood tests.

• #14 Shaken Baby Syndrome: Causes, Symptoms, Diagnosis, Treatment, Complications

  https://www.prepladder.com/neet-pg-study-material/pediatrics/shaken-baby-syndrome-causes-symptoms-diagnosis-treatment-prevention-and-complications

  (MRI) Magnetic resonance imaging: A strong magnetic field and radio waves are used in MRI to provide precise images of a child’s brain and spine. It can reveal brain bleeding, bruises, and indicators of low oxygen levels. An MRI is often performed two to three days after the injury since it is challenging to do one on an unsteady youngster. […] CT scan for computerized tomography: Cross-sectional views of the body are produced by a CT scan using X-ray imaging. A brain CT scan can be used to identify injuries that require immediate medical attention. To ascertain whether there are any other injuries, an abdominal CT scan may also be performed. […] The baby may need to be monitored in a pediatric intensive care unit, depending on the severity of the wounds.

• #14 Shaken Baby Syndrome: Causes, Symptoms, Diagnosis, Treatment, Complications

  https://www.prepladder.com/neet-pg-study-material/pediatrics/shaken-baby-syndrome-causes-symptoms-diagnosis-treatment-prevention-and-complications

  A youngster who has been violently shaken has to be examined by a variety of medical specialists as well as a child abuse specialist. […] The pediatrician will examine the child and inquire about their medical background. Several tests, such as the following, may be required to find injuries: […] Skeletal analysis: To assess if fractures are unintentional or intentional, several X-rays of the bones, maybe including the arms, hands, legs, feet, spine, ribs, and skull, may be taken. Finding prior fractures can also be aided by such testing. […] Eye examination: An eye exam can identify further eye injuries and eye hemorrhage. […] Blood test: Shaken baby syndrome-like symptoms can be brought on by certain genetic, metabolic, and coagulation abnormalities as well as bleeding and clotting issues. Some of these illnesses can be ruled out with the aid of blood tests.

• #15 Shaken Baby Syndrome – EyeWiki

  https://eyewiki.org/Shaken_Baby_Syndrome

  Child abuse is a significant social problem which is associated with a high morbidity and mortality. Shaken Baby Syndrome (SBS) is one form of physical child abuse, a non-accidental traumatic (NAT) brain injury. It is included in abusive head trauma classification. In 6% of reported cases of child abuse, an ophthalmologist is responsible for initially recognizing the abuse. Shaken Baby Syndrome (SBS) affects an estimated 1400 children/year in the United States and it is thought an astounding 2 million children are abused each year in the US alone. Retinal findings may be the only manifestation of this abuse. It is a diagnosis that has important medical-legal implications and one that cannot be overlooked as a child’s safety may very well be at stake. […] The ocular manifestations of child abuse are numerous. There may be signs of periorbital trauma (i.e. ecchymosis, lid edema, orbital fractures), anterior segment trauma (i.e. hyphema, iris prolapse, corneal laceration, cataract), or posterior segment trauma (i.e. vitreous hemorrhage, retinal detachment, optic nerve avulsion). There may be associated brain injury resulting in nystagmus, cortical blindness, encephalopathy, or cranial nerve palsies – most commonly subdural hemorrhage. Retinal hemorrhages are the cardinal manifestation of SBS. The incidence of retinal hemorrhages in SBS is approximately 85%. A prospective case series at Lille University in France found that 27% of children with confirmed intentional head injury (NAT to the head) had mild or moderate retinal hemorrhages, and 57% had severe hemorrhages. Classically, children with SBS have retinal hemorrhages which are multilayered preretinal, intraretinal, and subretinal. They are usually too numerous to count and extend out to the retinal periphery (i.e. not just confined to the posterior pole).

• #15 Shaken Baby Syndrome – EyeWiki

  https://eyewiki.org/Shaken_Baby_Syndrome

  Perhaps the greatest diagnostic clue is a detailed history that is incompatible with the extent and severity of the injuries found on dilated fundus exam. Suspected abusers may confess to investigators in up to 47% of cases. A child with classic evidence supporting physical abuse (i.e. old fractures, bruises of varying ages, signs of neglect, new sleep or behavioral issues, unexplained mental status changes) should alert the clinician to request a dilated fundus exam looking for SBS. Subdural hemorrhage, occipital lobe insult, and Glasgow Coma Scale (GCS) 15 are important risk factors for retinal hemorrhages. Not all patients will have obvious non-ocular findings, however, and clinicians should maintain a low threshold for dilated fundus examination. […] Overall, prevention is the best therapy. Many hospitals and healthcare centers offer classes and education on how to cope with the stresses of parenthood. Ophthalmic exam findings that suggest SBS necessitate urgent, comprehensive evaluation in the emergency department to reduce morbidity and mortality. Nonreactive pupils indicate a substantial risk of mortality. For these patients, ventilatory support and neurosurgical consultation should be pursued immediately. Retinal Hemorrhages and orbital fractures are associated with higher mortality, and the presence of these findings should be communicated clearly with all providers involved in the patient’s care.

• #16 Shaken baby syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007578.htm

  Shaken baby syndrome is a severe form of child abuse caused by violently shaking an infant or child. […] The symptoms can vary, ranging from mild to severe. They may include: Convulsions (seizures), Decreased alertness, Extreme irritability or other changes in behavior, Lethargy, sleepiness, not smiling, Loss of consciousness, Loss of vision, No breathing, Pale or bluish skin, Poor feeding, lack of appetite, Vomiting. […] There may not be any physical signs of injury, such as bruising, bleeding, or swelling. In some cases, the condition can be difficult to diagnose and may not be found during an office visit. However, rib fractures are common and can be seen on x-rays. […] An eye doctor may find bleeding behind the baby’s eye or retinal detachment. There are, however, other causes of bleeding behind the eye and they should be ruled out before diagnosing shaken baby syndrome. Other factors must be considered. […] Call your health care provider if a child has any of the above signs or symptoms, regardless of how mild or severe they are. Also call if you think a child has shaken baby syndrome.

• #17 Abusive Head Trauma (Shaken Baby Syndrome) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/shaken.html

  Abusive head trauma is a head or neck injury from physical child abuse. It happens when someone shakes a baby or hits the baby against something hard. […] Parents or caregivers often won’t say that the child was shaken or hit, so doctors may not know to check for head injury. Many signs of abusive head trauma, like fussiness and throwing up, are common in routine childhood illnesses. So it can be hard for doctors to figure out that a baby was harmed. […] If abusive head trauma is suspected, doctors will: Do an eye exam to look for bleeding inside the eyes. Order X-rays of all the bones to look for new or healing breaks, which happen most in the arms, legs, skull, and ribs. Order a CT or MRI of the head to look for: broken bones in the head (skull fractures), brain swelling, brain bleeding.

• #18

  https://www.aapos.org/glossary/shaken-baby-syndrome

  Shaken baby syndrome (SBS), also known as non-accidental trauma (NAT), is a diagnosis that may include a combination of findings including broken long bones such as arms or legs, skull fractures, brain bleeding and retinal hemorrhages. […] An eye examination by a trained examiner is part of an overall evaluation of a baby when abuse is suspected. Other tests may include imaging tests of the brain (CT or MRI), bone x-rays (to check for old and new fractures), and a social services evaluation. Blood tests may also be done to check for other conditions such as a bleeding disorder. […] For any child suspected to have suffered non-accidental trauma, the physician is required by law in the US to report the case to a designated governmental agency.

• #19 Shaken Baby Syndrome – What You Need to Know

  https://www.drugs.com/cg/shaken-baby-syndrome.html

  How is shaken baby syndrome diagnosed? […] Healthcare providers often look for certain injuries. These include any bruising in babies younger than 4 months, and bruising around the ears, neck, and torso of children younger than 4 years. Your baby may need any of the following tests: […] Ophthalmoscopy allows healthcare providers to see the back of your baby’s eye. They may use eye drops to dilate the pupil. This helps them see the back of your baby’s eyes clearly. […] CT or MRI pictures of your baby’s head may show bleeding and swelling. Your baby may be given contrast liquid to help healthcare providers see the bleeding and swelling better. Tell the healthcare provider if your baby has ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your baby has any metal in or on his or her body.

• #20 Shaken baby syndrome or another diagnosis? | The BMJ

  https://www.bmj.com/rapid-response/2011/10/30/shaken-baby-syndrome-or-another-diagnosis

  We read the recent papers and editorials on the shaken baby syndrome with great interest. These discuss the possible aetiology of this disorder, but fail to address the differential diagnoses which need to be taken into account when confronted with a baby with the findings of acute encephalopathy accompanied by subdural and retinal haemorrhages. […] A second disorder which may present in an identical manner to the shaken baby syndrome is hemophagocytic lymphohistiocytosis (HLH). […] The presence of anaemia, thrombocytopenia, abnormal liver enzymes and hepatosplenomegaly as well as coagulation disorders should raise suspicions of HLH. More extensive investigations including bone marrow aspiration, T2 weighted MRI scan of the brain, triglyceride and serum ferritine levels will be necessary to confirm the diagnosis. […] Therefore it is essential that other possible causes are eliminated before this diagnosis is pronounced.

• #21 Assessment of Shaken Infant Syndrome – 0070-525.10 – DCFS Policy Institute Website

  https://policy.dcfs.lacounty.gov/Policy?id=5751

  This policy guide provides information on assessing for and observing, gathering and assessing evidence of Shaken Infant Syndrome. […] Shaken Infant Syndrome, also known as Shaken Baby Syndrome or Whiplash Shaken Infant Syndrome, is the most common cause of child fatality due to abuse by violent shaking. […] Only medical personnel may provide the diagnosis of Shaken Infant Syndrome. Shaken Infant Syndrome is diagnosed through medical finding of intra-cranial, intra-ocular and/or skeletal injuries. A consultation must occur between the CSW, Public Health Nurse and medical provider to obtain a complete medical history and medical examination to assist in formulating an accurate assessment.

• #22 Rethinking Shaken Baby Syndrome : NPR

  https://www.npr.org/2011/06/29/137471992/rethinking-shaken-baby-syndrome

  Other scientists built on his research. Now shaken baby syndrome is diagnosed when doctors find unexplained bleeding on the brain and two other symptoms: bleeding behind the retinas and brain swelling. This constellation of symptoms is referred to as „the triad.” […] Too many medical experts see that triad of symptoms and conclude a child has been shaken without considering other possibilities, Guthkelch says. „I don’t think that the famous triad, however well some people think it’s defined, can ever be so well-defined that you can say that and nothing else cause it that meaning shaking.” […] Still, while shaken baby syndrome has been a widely accepted diagnosis for decades, a growing number of medical experts particularly forensic pathologists now question the diagnosis. […] There are no exact numbers on shaken baby syndrome cases. The National Center on Shaken Baby Syndrome, a resource and advocacy group, estimates there are about 1,200 to 1,400 cases a year of severe or fatal head trauma from child abuse.

• #22 Rethinking Shaken Baby Syndrome : NPR

  https://www.npr.org/2011/06/29/137471992/rethinking-shaken-baby-syndrome

  Guthkelch says doctors need to be extra cautious when medicine reaches the courtroom. Medical knowledge changes over time, but the criminal justice system wants certainty to determine guilt or innocence. „In a case of measles,” he says, „if you get the diagnosis wrong, in seven days’ time it really doesn’t matter because it’s cleared up anyhow. If you get the diagnosis of fatal shaken baby syndrome wrong, potentially someone’s life will be terminated.”

• #23 Robert Roberson and the controversy of shaken baby syndrome | The Texas Tribune

  https://www.texastribune.org/2024/10/17/robert-roberson-shaken-baby-controversy/

  The American Academy of Pediatrics embraces the diagnosis, but courts have thrown out some cases, calling it junk science. […] Experts are divided on the use of shaken baby syndrome diagnoses in criminal cases. […] This controversial medical diagnosis and disputed legal theory has divided courts, doctors, lawyers and law enforcement, with some calling it junk science and others continuing to embrace it as key to identifying and stopping child abuse. […] Starting in the 1980s, shaken baby syndrome was commonly diagnosed when doctors detected what’s known as the triad of symptoms unexplained bleeding on the brain, bleeding behind the retinas and brain swelling. […] Doctors, wary of missing cases of extreme child abuse, latched onto the diagnosis as a way to explain otherwise inexplicable symptoms.

• #24 Physical Child Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1176849-workup

  History and physical examination findings guide which laboratory and diagnostic imaging studies are performed. Concerns to consider and their corresponding screening tools may include: […] Quality photodocumentation of cutaneous injuries, such as burns, bite marks, bruises, or other injuries is very helpful in cases of child physical abuse. […] Discussing CNS injury and physical abuse inevitably leads to a discussion of abusive head trauma (AHT), previously referred to by multiple other names including shaken baby syndrome (SBS) or shaking-impact syndrome. The mechanism of injury involves rotational acceleration-deceleration and shearing forces to the child’s developing brain tissue (i.e., shaking) with or without associated head impact, and has been consistently supported by perpetrator statements.

• #25

  https://www.fox9.com/news/critics-parents-question-diagnosis-of-shaken-baby-syndrome

  A growing number of medical experts believe the diagnosis of shaken baby syndrome is being misdiagnosed in too many cases that often end up breaking up innocent families. […] Doctor’s concluded he was the victim of abusive head trauma (AHT), a new term for shaken baby syndrome (SBS). […] Since researchers first identified the phenomenon with studies on monkeys, there have been three symptoms used to diagnose shaken baby syndrome: a subdural hematoma, when blood fills the space between the brain and skull; cerebral edema which is swelling of the brain; and retinal hemorrhage, bleeding in the back of the eye. […] Ophoven is part of a chorus of expert witnesses now convinced SBS is being misdiagnosed by pediatricians, when there is no other sign of child abuse. […] All three say there are a variety of causes for those same three symptoms, including viral and bacterial infections and even a premature birth or vitamin deficiency.

• #26

  https://www.fox29.com/news/critics-parents-question-diagnosis-of-shaken-baby-syndrome

  A growing number of medical experts believe the diagnosis of shaken baby syndrome is being misdiagnosed in too many cases that often end up breaking up innocent families. […] Doctor’s concluded he was the victim of abusive head trauma (AHT), a new term for shaken baby syndrome (SBS). […] Since researchers first identified the phenomenon with studies on monkeys, there have been three symptoms used to diagnose shaken baby syndrome: a subdural hematoma, when blood fills the space between the brain and skull; cerebral edema which is swelling of the brain; and retinal hemorrhage, bleeding in the back of the eye. […] Ophoven is part of a chorus of expert witnesses now convinced SBS is being misdiagnosed by pediatricians, when there is no other sign of child abuse. […] All three say there are a variety of causes for those same three symptoms, including viral and bacterial infections and even a premature birth or vitamin deficiency.

• #27 Critics, parents question diagnosis of shaken baby syndrome | FOX 10 Phoenix

  https://www.fox10phoenix.com/news/critics-parents-question-diagnosis-of-shaken-baby-syndrome

  Ophoven is part of a chorus of expert witnesses now convinced SBS is being misdiagnosed by pediatricians, when there is no other sign of child abuse. […] All three say there are a variety of causes for those same three symptoms, including viral and bacterial infections and even a premature birth or vitamin deficiency. […] The American Academy of Pediatrics supports pediatricians in their diagnosis of abusive head trauma. These diagnoses are reached only after careful and thoughtful examination and review. […] The Academy’s research publication, Pediatrics, published a study last year that looked at expanding the diagnostic criteria for SBS beyond the customary three, to six different symptoms, including head and neck trauma.

• #28 Diagnosing Shaken Baby Syndrome And Child Abuse : Shots – Health News : NPR

  https://www.npr.org/sections/health-shots/2015/07/29/427449852/doctors-devise-a-better-way-to-diagnose-shaken-baby-syndrome

  To tell whether a baby has been injured or killed by being shaken, the courts use three hallmark symptoms: bleeding and swelling in the brain and retinal bleeding in the eyes. […] So researchers have developed and validated a tool doctors can use to distinguish between head injuries resulting from abuse and those from accidents or medical conditions. […] „It is vitally important that abuse head trauma is diagnosed accurately so that the team looking after the child can ensure that they receive appropriate support and are protected from further harm,” lead study author Laura Elizabeth Cowley, a doctoral student at the Cardiff University School of Medicine in the U.K., said in an email. […] The tool itself is simple: listing rib fracture, seizures, long-bone fractures, bruises on the head or neck, periods of not breathing called apnea and bleeding in the retina of the eyes.

• #28 Diagnosing Shaken Baby Syndrome And Child Abuse : Shots – Health News : NPR

  https://www.npr.org/sections/health-shots/2015/07/29/427449852/doctors-devise-a-better-way-to-diagnose-shaken-baby-syndrome

  By using a standard that at least three of the six symptoms were needed to presume abuse, the method correctly identified 82 percent of 133 cases as not abusive. […] „Part of the challenge is that there is no gold standard for making a diagnosis of child abuse you can’t do a blood test,” said Cindy Christian, chair of both Child Abuse and Neglect Prevention at The Children’s Hospital of Philadelphia and the American Academy of Pediatrics’ Committee on Child Abuse and Neglect. […] More than a half million U.S. children suffer abuse each year, including approximately 30 cases of abusive head trauma among every 100,000 infants, according to the American Academy of Pediatrics. […] In 2009, the AAP reclassified „shaken baby syndrome” as abusive head trauma to be more inclusive of all the ways a child’s head can be injured through abuse, including but not limited to violent shaking.

• #28 Diagnosing Shaken Baby Syndrome And Child Abuse : Shots – Health News : NPR

  https://www.npr.org/sections/health-shots/2015/07/29/427449852/doctors-devise-a-better-way-to-diagnose-shaken-baby-syndrome

  Yet a strong body of research shows that shaking can injure infants and toddlers and cause these symptoms. […] When a child comes in with those symptoms, pediatricians conduct a thorough physical exam to look for other injuries, get a full history from the parents and look for inconsistencies in caregivers’ stories. […] „All of our clinical experience and evidence shows that shaking can be extraordinarily harmful to a baby,” she said.

• #29 Shaken Baby Syndrome: A Diagnosis That Divides the Medical World – The New York Timesbarsbarsbars

  https://www.nytimes.com/2015/09/14/us/shaken-baby-syndrome-a-diagnosis-that-divides-the-medical-world.html

  Shaken baby syndrome has been a recognized diagnosis for several decades, though many medical professionals now prefer the term abusive head trauma. It is defined by a constellation of symptoms known as the triad: brain swelling, bleeding on the surface of the brain and bleeding behind the eyes. […] While many doctors, maybe most, still swear by the diagnosis, a growing number have lost faith. […] But these skeptics assert that factors other than shaking, and having nothing to do with criminal behavior, may sometimes explain the triad. […] But after the trial, he rethought his testimony and in effect became a penitent. He is now convinced that the diagnosis has been invoked too readily in criminal cases and that other causes might explain any bleeding and brain swelling. […] Without question, Dr. Barnes said, abuse exists, “and we have to do our duty to protect children.” […] But families need protection, too, he

• #30 The evidence base for shaken baby syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC381308/

  The phrase shaken baby syndrome evokes a powerful image of abuse, in which a carer shakes a child sufficiently hard to produce whiplash forces that result in subdural and retinal bleeding. […] Shaken baby syndrome is usually diagnosed on the basis of subdural and retinal haemorrhages in an infant or young child, although the diagnostic criteria are not uniform, and it is not unusual for the diagnosis to be based on subdural or retinal haemorrhages alone. […] Having reviewed the evidence base for the belief that perimacular folds with retinal haemorrhages are diagnostic of shaking, Lantz et al were able to find only two flawed case-control studies, much of the published work displaying an absence of precise and reproducible case definition, and interpretations or conclusions that overstep the data. […] If the concept of shaken baby syndrome is scientifically uncertain, we have a duty to re-examine the validity of other beliefs in the field of infant injury. […] We need to reconsider the diagnostic criteria, if not the existence, of shaken baby syndrome.

• #31

• #32 How Can Doctors Be Sure a Baby’s Been Shaken? – The Atlantic

  https://www.theatlantic.com/health/archive/2014/11/how-can-doctors-be-sure-a-babys-been-shaken/382632/

  At least 19 cases relying solely on SBS have been overturned in recent years. […] Tuerkheimer pointed out that the Del Prete decision is notable because the facts of her case were so typical. […] The criminal justice system has not moved quickly enough to account for the changes in scientific evidence. […] While new medical evidence and better advances in diagnosis may curtail future prosecutions based solely on the classic SBS triad, the justice system has been slow to change.

• #33 What to know about shaken baby syndrome as a Texas man could be first in US executed over it

  https://www.wapt.com/article/shaken-baby-syndrome-texas-execution/62607002

  The diagnosis refers to a serious brain injury caused when a child’s head is injured through shaking or some other violent impact, like being slammed against a wall or thrown on the floor, usually by an adult caregiver, said Dr. Suzanne Haney, a child abuse pediatrician and member of the American Academy of Pediatrics Council on Child Abuse and Neglect. The term was changed in 2009 to abusive head trauma, a more inclusive diagnosis, Haney said. There are about 1,300 reported cases of shaken baby syndrome/abusive head trauma in the U.S. each year, according to the National Center on Shaken Baby Syndrome. […] Critics allege doctors have been focused on concluding child abuse due to shaken baby syndrome whenever a triad of symptoms — bleeding around the brain, brain swelling and bleeding in the eyes — was found. Critics say doctors have not considered that things like short falls with head impact and naturally occurring illnesses like pneumonia, could mimic an inflicted head injury.

• #34

  https://link.springer.com/article/10.1007/s00247-018-4158-0

  Unequivocally, shaken baby syndrome is real. […] The findings of subdural hematoma, retinal hemorrhage and hypoxic-ischemic encephalopathy remain highly suggestive of shaken baby syndrome, particularly in the absence of evidence of an impact injury. […] In the absence of an obvious alternative explanation, the presence of any one, any combination of, or all three of these findings warrants a comprehensive, multidisciplinary medical and social workup and evaluation for child abuse. […] The diagnosis of abusive head trauma in children is not solely based on the findings of subdural hematoma, hypoxic-ischemic encephalopathy and retinal hemorrhage it never has been. The diagnosis of abusive head trauma is based on a thorough medical, forensic and social investigation that includes the exclusion of alternative diagnoses, underlying disease and accidental trauma. […] Responsible and reputable medical professionals are extremely careful in making the diagnosis of abusive head trauma and not misdiagnosing another condition as abusive head trauma.

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