The Case for Shaking

Dias, Mark S.

doi:10.1016/b978-1-4160-6393-3.00041-5

Cited by 15 publications

(9 citation statements)

References 67 publications

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“…There still remains discussion over whether shaking alone or shaking with blunt trauma is necessary for the injuries of these abused children but confessional evidence is quite striking that shaking alone can cause AHT [30][31][32]. Dias [33] made the case that shaking alone can be causative mechanism and significantly questions the validity of the biomechanical model of Duhaime et al [16]. In 2016, Narang et al [3] documented that both AHT and Shaken baby syndrome (SBS) are generally accepted diagnoses in the medical community.…”

Section: Etiology Of Head Trauma In Infants and Young Children And Nomentioning

confidence: 99%

“…The data for injury thresholds in these studies was derived from adult primates undergoing single, non-impact accelerations [48][49][50][51]. The differences in intrinsic material properties of the infant skull, brain, cerebrospinal fluid (CSF) and blood vessels versus an adult human or primate or effects of repeated injury was not considered [33]. We need to develop a better understanding of these critical differences to develop better biomechanical studies, approximating real life situations, that will provide more accurate and reliable information.…”

Section: Historymentioning

confidence: 99%

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Consensus statement on abusive head trauma in infants and young children

et al. 2018

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Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.

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Section: Etiology Of Head Trauma In Infants and Young Children And Nomentioning

confidence: 99%

Section: Historymentioning

confidence: 99%

Consensus statement on abusive head trauma in infants and young children

et al. 2018

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“…78 Vitamin C and D deficiency, sepsis, and specific infections were considered important. 17,80,81,[83][84][85][86][87] The average age of the explained SUDI cases is higher (median 127d) with a higher proportion of deaths in the first month of life (18%) and after 196 days (35%). There is a long list of intrinsic demographic factors common to both SIDS and infants who die with unexplained RDH (when classified as SBS)notably age, sex, prematurity, and congenital anomalies.…”

Section: Demographics Of Sbs and Sids Exogenous Triggersmentioning

confidence: 99%

“…1). 17,80,81,[83][84][85][86][87] The average age of the explained SUDI cases is higher (median 127d) with a higher proportion of deaths in the first month of life (18%) and after 196 days (35%). 83 Recent studies have shown that the peak age of SIDS has declined, possibly because of an increased proportion of infants who are cosleeping.…”

Section: Demographics Of Sbs and Sids Exogenous Triggersmentioning

confidence: 99%

Infants dying suddenly and unexpectedly share demographic features with infants who die with retinal and dural bleeding: a review of neural mechanisms

Squier

Mack

Jansen

2016

Develop Med Child Neuro

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The cause of death in infants who die suddenly and unexpectedly (sudden unexpected death in infancy [SUDI]) remains a diagnostic challenge. Some infants have identified diseases (explained SUDI); those without explanation are called sudden infant death syndrome (SIDS). Demographic data indicate subgroups among SUDI and SIDS cases, such as unsafe sleeping and apparent life-threatening events. Infants dying suddenly with retinal and dural bleeding are often classified as abused, but in many there is no evidence of trauma. Demographic features suggest that they may represent a further subgroup of SUDI. This review examines the neuropathological hypotheses to explain SIDS and highlights the interaction of infant oxygen-conserving reflexes with the brainstem networks considered responsible for SIDS. We consider sex- and age-specific vulnerabilities related to dural bleeding and how sensitization of the dural innervation by bleeding may influence these reflexes, potentially leading to collapse or even death after otherwise trivial insults.

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“…This certainly should not be considered "violent" shaking". Whether shaking alone can cause subdural hemorrhage is still a zealously debated hypothesis [3,4]. As medicine has proven through the ages, experience alone is not a substitute for the scientific method and does not prove a hypothesis [4].…”

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confidence: 99%