“Shaken baby syndrome” and forensic pathology

  title={“Shaken baby syndrome” and forensic pathology},
  author={Waney Squier},
  journal={Forensic Science, Medicine, and Pathology},
  • W. Squier
  • Published 28 January 2014
  • Medicine
  • Forensic Science, Medicine, and Pathology
I welcome the creation of a forum to air opposing views in this ‘‘very contentious and hotly debated area’’ [1]. The critical issue is why, after more than 40 years, shaken baby syndrome/ abusive head trauma (SBS/AHT) remains controversial. Contrary to Byard’s suggestion, the SBS/AHT controversy is not about whether infants can be damaged or killed by violent shaking or abuse; of course they can. The real controversy is over whether shaking or abuse may reliably be inferred from specific… 
5 Citations
A Conceptual Overview of Axonopathy in Infants and Children with Allegedly Inflicted Head Trauma
Fatal, allegedly inflicted pediatric head trauma remains a controversial topic in forensic pathology and requires a philosophical understanding of the diffuse axonal injury spectrum disorders.
Evaluating the evidentiary value of the analysis of skeletal trauma in forensic research: A review of research and practice.
A detailed literature review was performed to assess the value and scientific rigour of the current research in forensic anthropology, forensic pathology and biomechanics that attempts to provide an objective framework in which forensic practitioners can assess and interpret BFT injuries.
Circularity bias in abusive head trauma studies could be diminished with a new ranking scale
Abstract Causality in abusive head trauma has never been fully established and hence no gold standard exists for the diagnosis. Implications hereof include bias introduced by circular reasoning and a
Using the table in the Swedish review on shaken baby syndrome will not help courts deliver justice
This paper presents a comparison study of forensic pathology and clinical forensic medicine in the context of child protection and neonatal intensive care units in Germany and the United States.
Forensic Pathology Aspects of Sudden Unexpected Death in Infancy and Childhood


“Shaken baby syndrome” and forensic pathology: an uneasy interface
  • R. Byard
  • Medicine
    Forensic Science, Medicine, and Pathology
  • 2013
The author considers it veryunlikely that an infant would be able to engage in normalactivities in an apparently unaffected manner after such aninsult, and considering the severity of the injury (i.e., the event has resulted in death) and the rapidity with whichintracranialpressure has beenshowntorise in animal modelsfollowing blunt trauma.
The shaken baby syndrome. A clinical, pathological, and biomechanical study.
It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.
Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome)
It is proved that shaking of a subset of lambs can result in death, without an additional head impact being required.
Retino‐Dural Hemorrhage of Infancy
The pathology of each of these signs and their pathophysiology is examined, and the importance of considering the birth, early clinical history, and predisposing vulnerabilities when examining a case of suspected abuse is emphasized.
Abusive Head Trauma in Infants and Children
The American Academy of Pediatrics recommends that pediatricians develop skills in the recognition of signs and symptoms of abusive head injury, including those caused by both shaking and blunt impact, consult with pediatric subspecialists when necessary, and embrace a less mechanistic term, abusive head trauma, when describing an inflicted injury to the head and its contents.
Neuropathology of inflicted head injury in children.
The authors’ neuro‐pathological findings support this theory and demonstrate injuries at the cranio‐cervical junction that account for the apnoea and hypoxia in infants with non‐accidental injury.
The neuropathology of infant subdural haemorrhage.
As the possibility of non-accidental injury is often first raised by a radiologic report of subdural bleeding, it becomes critically important in the interpretation of the scan appearances to understand the unique physiology and anatomy of the infant dura.
Infantile Subdural Haematoma and its Relationship to Whiplash Injuries
Subdural haematoma is one of the commonest features of the battered child syndrome, yet by no means all the patients so affected have external marks of injury on the head. This suggests that in some
Dural haemorrhage in non‐traumatic infant deaths: does it explain the bleeding in ‘shaken baby syndrome’?
J. F. Geddes, R. C. Tasker, A. K. Hackshaw, C. D. Nickols, G. G. W. Adams, H. L. Whitwell and I. Scheimberg (2003) Neuropathology and Applied Neurobiology 29, 14–22 
Dural haemorrhage in
Neuropathology of inflicted head injury in children. II. Microscopic brain injury in infants.
The observation that the predominant histological abnormality in cases of inflicted head injury in the very young is diffuse hypoxic brain damage, not DAI can be explained in one of two ways: either the unmyelinated axon of the immature cerebral hemispheres is relatively resistant to traumatic damage, or in shaking-type injuries the brain is not exposed to the forces necessary to produce DAI.