Insufficient evidence for ‘shaken baby syndrome’ – a systematic review

@article{Lyne2017InsufficientEF,
  title={Insufficient evidence for ‘shaken baby syndrome’ – a systematic review},
  author={Niels Lyn{\o}e and Göran Elinder and Boubou Hallberg and M{\aa}ns Ros{\'e}n and Pia C. Maly Sundgren and Anders Eriksson},
  journal={Acta Paediatrica},
  year={2017},
  volume={106}
}
Shaken baby syndrome has typically been associated with findings of subdural haematoma, retinal haemorrhages and encephalopathy, which are referred to as the triad. During the last decade, however, the certainty with which the triad can indicate that an infant has been violently shaken has been increasingly questioned. The aim of this study was to determine the diagnostic accuracy of the triad in detecting that an infant had been shaken. The literature search was performed using PubMed, Embase… 
Extensive shaken baby syndrome review provides a clear signal that more research is needed
TLDR
There is an imminent risk that the current paper by Lynøe et al. (1) will lead to fewer reports from physicians to social services and that children who are being exposed to abuse will remain undiagnosed and limited help to paediatricians on how to handle cases of suspected AHT is offered.
The Swedish shaken baby syndrome report and review: what does the latest knowledge tell us?
TLDR
The Geddes Hypothesis, known as the ‘Geddes hypothesis’, is that thin film SDH and RH could be caused by severe hypoxia in association with brain swelling and raised central venous pressure, and the thin film of SDH in the triad appears to be unreliable as evidence of AHT/SBS.
Subdural haemorrhage in infants: abuse or natural causes? The importance of thorough child death review
TLDR
In a study based on the records of the National Board of Forensic Medicine in Sweden together with death certification records for the period 1994–2013 inclusive, Andersson and Thiblin have attempted to identify all infants with a probable diagnosis of AHT, and conclude that amongst the infants whose deaths were certified as being due to sudden infant death syndrome (SIDS), there were no deaths from AHT.
Is there an evidentiary basis for shaken baby syndrome? The conviction of Joby Rowe
  • C. Brook
  • Medicine
    Australian Journal of Forensic Sciences
  • 2019
TLDR
Joby Rowe’s 2018 conviction for child homicide was reliant upon forensic evidence provided by expert medical witnesses, but crucial aspects of the expert's opinions lacked a scientific basis and were based instead on confession studies.
Shaken baby syndrome is real
TLDR
This study has many issues, beginning with legitimate questions of bias in its conception and backing, and one must seriously question the credibility of any study that blatantly gives credence to widely discredited references.
Shaken Baby Syndrome
The shaken baby syndrome is highly contentious. The term is characteristically applied to infants showing a triad of subdural haemorrhage, retinal haemorrhage and encephalopathy. These three features
Consensus should be adapted to the evidence and not vice‐versa
TLDR
It is agreed that SDH is probably the core issue when discussing isolated violent shaking, spontaneous SDH and chronic SDH, and that if violent shaking is suspected, a magnetic resonance imaging scan of the cervical spine should be the priority, rather than an ophthalmological examination.
Initial response of the European Society of Paediatric Radiology and Society for Pediatric Radiology to the Swedish Agency for Health Technology Assessment and Assessment of Social Services’ document on the triad of shaken baby syndrome
TLDR
It is concluded that there is limited scientific evidence that the triad of findings and thus its individual components indicate the shaken baby syndrome and there is insufficient scientific evidence to assess the diagnostic accuracy of theTriad to identify shook baby syndrome.
Widening of the pericerebral space in infants – consultative problems
TLDR
A review of medical records provided evidence to conclude that the subdural hygromas diagnosed in both infants had a post-traumatic origin, and factors were selected for consideration in medicolegal assessment.
The legal challenges to the diagnosis of shaken baby syndrome or how to counter 12 common fake news
TLDR
It is important that medical experts master an extensive knowledge regarding the pathophysiology of the lesions of SBS, in particular infantile subdural hematomas, as well as other CSF-related conditions, and the role that pediatric neurosurgeons should play in the clinical and medicolegal management of patients.
...
...

References

SHOWING 1-10 OF 73 REFERENCES
The “Shaken Baby” syndrome: pathology and mechanisms
TLDR
The pathology and mechanisms of the three physiologically associated findings which constitute the “triad” and are seen in infants suffering from a wide range of non-traumatic as well as traumatic conditions are focused on.
A Witnessed Short Fall Mimicking Presumed Shaken Baby Syndrome (Inflicted Childhood Neurotrauma)
TLDR
This paper presents critical information upon which the authors are often required to act and includes more clinical information than most of the previous studies in this area.
Retinal hemorrhages and shaken baby syndrome: an evidence-based review.
The shaken baby syndrome: review of 10 cases.
  • Lee, So, Fong, Luk
  • Medicine
    Hong Kong medical journal = Xianggang yi xue za zhi
  • 1999
TLDR
Peripheral signs are uncommon and a high degree of suspicion is needed for the management to be successful and medical practitioners should be alert to the occurrence of abusive head injury in children.
Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review
TLDR
It is shown that apnoea and retinal haemorrhage have a high odds ratio for association with iBI, and key features that should be recorded in the assessment of children where iBI is suspected and may help clinicians to define the likelihood of iBI.
Funduscopic lesions associated with mortality in shaken baby syndrome.
  • M. Mills
  • Medicine
    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • 1998
Confessed abuse versus witnessed accidents in infants: comparison of clinical, radiological, and ophthalmological data in corroborated cases
TLDR
This study confirms the high diagnostic value of RH, SDH, and signs of impact for the differential diagnosis between AT and IHI, and examines prospectively corroborated cases of head injuries in infants.
Acceptance of Shaken Baby Syndrome and Abusive Head Trauma as Medical Diagnoses.
Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review
TLDR
The authors' systematic review confirms that although certain patterns of RH were far commoner in AHT, namely large numbers of RH in both the eyes, present in all layers of the retina, and extension into the periphery, there was no retinal sign that was unique to abusive injury.
...
...