A new study provides new evidence on shaken baby syndrome.
A new study suggests that babies can die by violent shaking alone — but not in the way doctors have previously thought.
A team of researchers who conducted autopsies on 35 babies in Miami, Dallas and Calgary, Alberta, report that when children die after being violently shaken, they die of neck injuries and not from brain trauma.
In the most contested cases, shaken baby syndrome is diagnosed based on a triad of internal injuries in the brain: subdural bleeding, retinal bleeding and brain swelling. There is no evidence of impact, like a skull fracture. And there’s also no obvious sign of the kind of neck injury that comes with severe whiplash. In the absence of such external injuries, biomechanical engineers have raised doubts about whether it’s even possible to shake a baby to death. Many doctors who treat abused children, on the other hand, say that clinical observations make it clear that this does happen.
Matshes’s research shows how death from shaking could in fact occur — but not because of the traditional triad of injuries to the brain. As NPR notes: “The new findings split a lot of the difference between the warring camps on shaken baby syndrome. For supporters, there’s evidence that shaking alone can lead to a baby’s death. But it also says skeptics were right to suggest it’s not the head injury that causes death and that shaking deaths are likely rare.”
The findings were just published in Academic Forensic Pathology, the journal of the National Association of Medical Examiners.
Shaken baby syndrome is commonly invoked to prosecute child abuse. But growing numbers of medical experts — particularly forensic pathologists — have raised doubts about the diagnosis.
Skeptics question whether it's possible to shake a baby so violently that the child dies from brain injury but without other visible marks or trauma to the neck and spine.
The confusion over the science sometimes results in the conviction of innocent parents and prison. A series of investigative reports called Post Mortem: Child Cases, this week by NPR, PBS Frontline and ProPublica told the stories of the wrongly convicted and looked at the case of Ernie Lopez, who is serving a 60-year prison sentence in Texas.
The authors of the new research did something novel. They looked at a baby's nerve roots. Those are hard to observe, because they are protected by the bone and spine. But by looking, the scientists say they found injuries that no one had observed before. "We contend that up until now, 'neck injuries' have not been seen, not because they were not present, but rather because the appropriate anatomical structures were not dissected," writes lead author Dr. Evan Matshes, a medical examiner in Calgary.
Links:
http://6thfloor.blogs.nytimes.com/2011/07/05/new-evidence-on-shaken-baby-syndrome/
http://www.npr.org/blogs/health/2011/07/02/137553701/autopsy-study-provides-new-theory-on-shaken-baby-syndrome?ps=sh_sthdl