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Medical Consensus

  • General 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.

    Read the full statement

    American Academy of Pediatrics

    AAP LogoThe 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.

    Read the full statement

    The World Health Organization

    WorldHealth Logo… the baby will be considered a possible victim of ‘shaken baby syndrome’, a form of child abuse that involves the violent shaking of an infant…According to Dr Kieran Moran, forensic paediatrician at Sydney Children’s Hospital, babies are victims of violent shaking mainly in their first year of life, as that is often when they cry inconsolably and when parents and carers become most frustrated.

    Read the full statement

    The American Association of Neurological Surgeons

    AmAssocNeuroSurg LogoShaken Baby Syndrome (also known as Shaken Impact Syndrome) is a serious form of abuse inflicted upon a child. It usually occurs when a parent or other caregiver shakes a baby out of anger or frustration, often because the baby will not stop crying.

    Read the full statement

    Canadian Joint Statement on Shaken Baby Syndrome/Abusive Head Trauma

    CanPaedSoc LogoShaken Baby Syndrome is a collection of findings, all of which may not be present in any individual child with the condition. Injuries that characterize Shaken Baby Syndrome are intracranial hemorrhage (bleeding in and around the brain); retinal hemorrhage (bleeding in the retina of the eye); and fractures of the ribs and at the ends of the long bones.

    Read the full statement

    The American Academy of Ophthalmology

    AmerAcadOph LogoShaken Baby Syndrome is a subset of Abusive Head Trauma characterized by repetitive acceleration-deceleration forces with or without blunt head impact resulting in a unique complex of ocular, intracranial, and sometimes other injuries, usually in infants…it has become widely recognized as one of the most serious manifestations of physical child abuse.

    Read the full statement

    The American Academy of Neurology

    AmerAcadNeur LogoShaken baby syndrome is a type of inflicted traumatic brain injury that happens when a baby is violently shaken. A baby has weak neck muscles and a large, heavy head. Shaking makes the fragile brain bounce back and forth inside the skull and causes bruising, swelling, and bleeding, which can lead to permanent, severe brain damage or death.

    Read the full statement

    Centers for Disease Control and Prevention

    CDC LogoAbusive head trauma (AHT), which includes shaken baby syndrome, is a preventable and severe form of physical child abuse that results in an injury to the brain of an infant or child. AHT is most common in children under age five, with children under one year of age at most risk. It is caused by violent shaking or blunt impact.

    Read the full statement

    The Royal College of Ophthalmologists and The Royal College of Paediatrics and Child Health

    RoyalColOpht LogoRoyalColPedsChHealth LogoA 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.

    Read the full statement

    French Society of Physical Medicine and Rehabilitation

    logo sofmerSBS is a type of inflicted, non-accidental or abusive head injury caused by shaking (either alone or combined with an impact). It mainly occurs in babies under the age of one.  It is thought that 180 to 200 children per year are victims of this type of abuse in France, although this value is certainly an underestimate. Failure to diagnose SBS increases the likelihood of recurrence.

    Read the full statement

Research

  • Articles Everyone Should Know

    These are some of the most relevant research articles about Shaken Baby Syndrome/Abusive Head Trauma that will aid a lay person wanting to learn more about this form of child abuse.

    Abusive head trauma: judicial admissions highlight violent and repetitive shaking

    by Jocelyn Kearl

    Catherine Adamsbaum, et al. Pediatrics: September 2010

    READ MORE

    Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

    by Jocelyn Kearl

    Ronald G. Barr. PNAS: 2012

    READ MORE

    A Daubert analysis of abusive head trauma/shaken baby syndrome

    by Jocelyn Kearl

    Sandeep Narang. Houston Journal of Health Law and Policy: 2011

    READ MORE

    Research

    by Jocelyn Kearl

    Articles Everyone Should Know

    These are some of the most relevant research articles about Shaken Baby Syndrome/Abusive Head Trauma that will aid a lay person wanting to learn more about this form of child abuse.

    Recent Research

    The list below contains the most recent research relevant to SBS/AHT published during the past few years. The list cites the article’s title, author(s), title of the periodical or book, publication date and a link to the abstract or full article (if available). 

     

    Brückenvenenverletzungen bei Schütteltrauma [Bridging vein injuries in shaken baby syndrome] Wittschieber, D., Muggenthaler, H., Mall, G, et al. The Radiologist. December 2020.

    Denialism Preserves Scientific Controversies: a Case Study of Abusive Head Trauma Research. Lynøe, N., & Eriksson, A. Journal of Controversies in Biomedical Research. December 2020.

    Trends in Abusive and Nonabusive Injury Hospitalizations in Young Children in Texas, 2004-2018. Cain CM, Mandell DJ, Thompson RR, et al. Child Maltreatment. December 2020. 

    Evaluating abusive head trauma in children < 5 years old: Risk factors and the importance of the social history. Notrica DM, Kirsch L, Misra S, et al. Journal of Pediatric Surgery. October 2020. 

    Head computed tomography in suspected physical abuse: time to rethink? Glenn K, Nickerson E, Bennett CV, et al. BMJ. October 2020. 

    Medicolegal issues in abusive head trauma for the pediatric neurosurgeon. Bass DI, Lee A, Browd SR, et al. Neurosurg Focus. November 2020. 

    Abusive head trauma: experience improves diagnosis. Porto L, Bartles MB, Zwaschka J, et al. Paediatric Neuroradiology. October 2020. 

    Occurrence of traumatic brain injury due to short falls with or without a witness by a nonrelative in children younger than 2 years. Amagasa S, Uematsu S, & Tsuji S. Journal of Neurosurgery. September 2020. 

    Skull fractures in abusive head trauma: a single centre experience and review of the literature. Sidpra J, ul Owase Jeelani N, Ong J, et al. Child's Nervous System. September 2020. 

    Identifying Maltreatment in Infants and Young Children Presenting with Fractures: Does Age Matter? Mitchell IC, Norat BJ, Auerbach M, et al. Academic Emergency Medicine. September 2020. 

    Catching the red eye: A retrospective review of factors associated with retinal hemorrhage in child physical abuse. Moody S, Casar AM, Jenkins T, et al. Journal of Pediatric Surgery. September 2020. 

    Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants. Eismann EA, Theuerling J, Cassedy A, Curry PA, Colliers T, & Makoroff K. Child Abuse & Neglect. October 2020. 

    Short term outcomes of children with abusive head trauma two years post injury: A retrospective study. Badger S, Waugh MC, Hancock J, Marks S, & Oakley K. Journal of Pediatric Rehabilitation Medicine. August 2020. 

    Are Complex Skull Fractures Indicative of Either Child Abuse or Major Trauma in the Era of 3-Dimensional Computed Tomography. Metz JB, Otjen JP, Perez F, et al. Pediatric Emergency Care. August 2020 [epub ahead of print]

    Identification of Abusive Head Trauma in High-Risk Infants: A Cost-Effectiveness Analysis. Norrbakhsh KA, Berger RP, & Smith JK. The Journal of Pediatrics. June 2020. 

    Intracranial Injury Among Children with Abuse-Related Long Bone Fractures. Chahla S & Ortega H. The Journal of Emergency Medicine. July 2020. 

    Abusive Head Trauma and a Delay in Presentation for Care. Kennedy JM, Ma J, Lyden E, & Haney SB. Pediatric Emergency Care. July 2020. 

    Pediatric Rib Fractures Identified by Chest Radiography. Ruest S, Kanaan G, Moore J, & Goldberg AP. Pediatric Emergency Care. May 2020. 

    Identifying Predictors of Physical Abuse Evaluation of Injured Infants. Eismann EA, Shapiro RA, Makoroff KL, et al. Pediatric Emergency Care. May 2020. 

    Determining the Tractional Forces on Vitreoretinal Interface Using Computer Simulation Model in Abusive Head Trauma. Suh DW, Song HH, Mozafari H, & Thoreson WB. Am J Ophthalmol. July 2020 [epub ahead of print]. 

    Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation*. Hendrix AD, Conway LK, & Baxter MA. Journal of Forensic Sciences. June 2020. 

    Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital. Loos MLHJ, Ahmed T, Bakx R, & van Rijn RR. Pediatric Surgery International. June 2020. 

    Cerebrospinal fluid interaction with cerebral cortext during pediatric abusive head trauma. Toma M, Dehesa-Baeza A, Chan-Akaley, et al. Journal of Pediatric Neurology. July 2020. 

    Disability and visual outcomes following suspected abusive head trauma in children under 2 years. Wright J, Painter S, Sujayeendra Kodagali S, et al. BMJ: Archives of Disease in Childhood.  July 2020. 

    Features of intracranial hemorrhage in cerebral venous thrombosis. Afifi K, Bellanger G, Buyck PJ, et al. Journal of Neurology. June 2020. 

    Incidence and Risk Factors for Abusive Head Trauma A Population-Based Study. Rebbe R, Mienko JA, & Martinson ML. Child Abuse Review. June 2020. 

    High Frequency of Previous Abuse and Missed Diagnoses Prior to Abusive Head Trauma: A Consecutive Case Series of 100 Forensic Examinations. Laurent-Vannier A, Bernard JY, & Chevignard M. Child Abuse Review. June 2020. 

    Abusive Head Trauma in Infants: Incidence and Detection of Prior Brain Injury. Sirmai N, Garside L, & Tzioumi D. Child Abuse Review. June 2020. 

    What Do Confessions Reveal about Abusive Head Trauma? A Systematic Review. Edwards GA, Maguire SA, Gaither JR, & Leventhal JM. Child Abuse Review. June 2020. 

    Impact of the Take 5 Safety Plan for Crying on the Occurrence of Abusive Head Trauma. Bechtel K, Gaither JR, & Leventhal JM. Child Abuse Review. April 2020. 

    Financial Impact of Abusive Head Trauma to Age 17. Steinbeigle R, Barr M, Barr RG, & Miller TR. Child Abuse Review. June 2020. 

    More data, more questions: No simple answer about which children should undergo screening neuroimaging for clinically occult abusive head trauma. Henry MK, Lindberg DM, & Wood J. Child Abuse & Neglect. September 2020 [epub ahead of print]

    Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review. Figueira Rodrigues Vieira G & Guedes Correa JF. Neuroradiology. June 2020. 

    Differences in Incidence and Case Fatality of Abusive Head Trauma. Nuño M, Shelley CD, Ugiliweneza B, et al. Child Abuse & Neglect. June 2020. 

    Descriptive data on intracranial hemorrhage related to fatal non-accidental head injury in a pediatric population. Delteil C. Kolopp M, Torrents J, et al. La Revue de Médecine Légale. May 2020. 

    Cerebrospinal Fluid Interaction with Cerebral Cortex during Pediatric Abusive Head Trauma. Toma M, Dehesa-Baeza A, Chan-Akaley R, et al. Journal of Pediatric Neurology. January 2020. 

    Abusive Head Trauma in Infants and Children. Narang SK, Fingarson A, Lukefahr J, and Council on Child Abuse a Neglect.  Pediatrics. March 2020. 

    Pediatric cervical spine injuries on CT: difference in accuracy of interpretations by pediatric versus non-pediatric radiologists. Hassan N, Butler C, DeCou J, et al. Emergency Radiology. April 2020. 

    Occult head injuries in infants evaluated for physical abuse. Henry MK, Feudtner C, Fortin K, Lindberg DM, Anderst JD, Berger RP, & Wood JN. Child Abuse & Neglect. May 2020. 

    Retinal and visual function in infants with non-accidental trauma and retinal hemorrhages. Kelly JP, Feldman K, Wright J, Ganti S, Metz JB, & Weiss A. Documenta Ophthalmologica. February 2020. 

    Risk Factors for Child Maltreatment Fatalities in a National Pediatric Inpatient Database. Kennedy JM, Lazortiz S, & Palusci VJ. Hospital Pediatrics. February 2020. 

    Predictors for Nonaccidental Trauma in Child with a Fracture - A National Inpatient Database Study. Zhao C, Starke M, Tompson J, & Sabharwal S. Journal of the American Academy of Orthopaedic Surgeons. February 2020. 

    Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Karmazyn B, Marine MB, Wanner MR, et al. Pediatric Radiology. January 2020. 

    Predicting abusive head trauma in children. Davies, F. Emergency Medicine Journal. doi: 10.1136/emermed-2019-209280

    Estimating the Relevance of Historical Red Flags in the Diagnosis of Abusive Head Trauma. Hymel KP, Lee G, Boos S, et al. The Journal of Pediatrics. 2020. 

    Validation of the PredAHT-2 prediction tool for abusive head trauma. Pfeiffer H, Cowley LE, Kemp AM, et al. Emergency Medicine Journal, BMJ. January 2020. 

    Characteristics of rib fractures in young abused children. Kriss S, Thompson A, Bertocci G, Currie M, & Martich V. Pediatric Radiology. January 2020. 

    Characteristics associated with spine injury on magnetic resonance imaging in children evaluated for abusive head trauma. Rabbitt AL, Kelly TG, Yan K, et al. Pediatric Radiology. January 2020. 

    Implementation of a brain injury screen MRI for infants at risk for abusive head trauma. Berger RP, Furtado AD, Flom LL, Fromkin JB, & Panigrahy A. Pediatric Radiology. January 2020. 

    Neonatal shaking brain injury changes psychological stress-induced neuronal activity in adult male rats. Ueda S, Yamaguchi T, & Ehara A. Neuroscience Letters. January 2020. 

    Memorandum Opinion and Order on the United States' Motion in Limine for Daubert Ruling Regarding the Admissibility and Scope of Defendant's Proposed Expert Witness. United States District Court for the District of New Mexico. December 2019

    Inequities in Pediatric Abusive Head Trauma According to Neighborhood Social and Material Deprivation: A Population-level Study in British Columbia, Canada. Beaulieu E, Jiang A, Zheng A, et al. Journal of Child Maltreatment. December 2019. 

    Paediatric abusive head trauma in the emergency department: A multicentre prospective cohort study. Babl FE, Pfeiffer H, Kelly P, et al. Journal of Paediatrics and Child Health. December 2019.  

    Long-term visual outcomes following abusive head trauma with retinal hemorrrhage. Weldy, E., Shimoda, A., Patnaik, J. et al. Journal of American Association for Pediatric Ophthalmology and Strabismus. December 2019. 

    MRI Findings in Pediatric Abusive Head Trauma: A Review. Orman G, Kralik SF, Meoded A, et al. Journal of Neuroimaging. November 2019. 

    Growth recovery lines: a specific indicator of child abuse and neglect? Spiller LR, Kellogg ND, Mercado-Deane MG, et al. Pediatric Radiology. September 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Child Neurology. June 2019. 

    Nonaccidental Trauma is an Independent Risk Factor for Mortality Among Injured Infants. Delaplain PT, Grigorian A, Won E, et al. Pediatric Emergency Care. August 2019. 

    Identifying Child Abuse Fatalities During Infancy. The American Academy of Pediatrics. Pediatrics. August 2019. 

    National Risk Factors for Child Maltreatment after Trauma: Failure to Prevent. Parreco J, Quiroz HJ, Willobee BA, et al. The American Surgeon. July 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Children Neurology. June 2019. 

    The "New Science" of Abusive Head Trauma. Lindberg D, Dubowitz H, Alexander RC, & Reece, RM. International Journal of Child Maltreatment: Research, Policy and Practice. July 2019. 

    Every child, every time: hospital-wide child abuse screening increases awareness and state reporting. Dudas L, Petrohoy G, Esernio-Jenssen D, et al. Pediatric Surgery Interational. July 2019. 

    Prevalence of metaphyseal injury and its mimickers in otherwise healthy children under two years of age. Eide P, Djuve A, Myklebust R. et al. Pediatric Radiology. May 2019. 

    Cerebellar lesions in pediatric abusive head trauma. Haas-Lude K, Roulet-Perez E, Döbler-Neumann M, et al. European Journal of Paediatric Neurology. May 2019. 

    Frequency of macroscopic intradural hemorrhage with and without subdural hemorrhages in early childhood autopsies. Cheshire EC, Biggs MJP, Hollingbury FE, et al. Forensic Science, Medicine, and Pathology. June 2019. 

    Abusive head trauma, healthcare, and childhood professionals' lack of knowledge is detrimental to the child's interest. Laurent-Vannier A & Chevignard M. Archives de Pediatrie. May 2019. 

    Infant skull fracture risk for low height falls. Majiaghamemar M, Lan IS, Christian C, Coats B, Margulies SS. International Journal of Legal Medicine. May 2019. 

    Classic Metaphyseal Lesions among Victims of Abuse. Adamsbaum C, de Boissieu P, Teglas JP, et al. Pediatrics. April 2019. 

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Characteristics that distinguish abusive from nonabusive cases of sudden unexpected infant deaths. Bechtel K, Derbyshire M, Gaither JR, Leventhal JM. Pediatric Emergency Care. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part II: a systematic review of mathematical and physical models Part II: a systematic review of mathematical and physical models. van Zandwijk JP, Vester MEM, Bilo RA, van Rijn RR, Loeve AJ. Forensic Science, Medicine and Pathology. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part I: A systematic review of animal models Part I: A systematic review of animal models. Vester MEM, Bilo RAC, Loeve AJ, van Rijn RR, van Zandwijk JP. Forensic Science, Medicine and Pathology. March 2019. 

    Prevalence of Abuse Among Young Children With Rib Fractures. Paine CW, Fakeye O, Christian CW, and Wood JN. Pediatric Emergency Care. February 2019. 

    Age-Related Mortality in Abusive Head Trauma. Nuño M, Ugiliweneza B, Bardini R, et al. The Journal of Trauma and Acute Care Surgery. March 2019. [epub ahead of print]

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Consensus statement on abusive head trauma: additional endorsements. Choudhary AK, Suarez PD, Binenbaum G, et al. Pediatric Radiology. March 2019. 

    Early Recognition of Physical Abuse: Bridging the Gap between Knowledge and Practice. Berger R and Lindberg DM. Pediatrics. January 2019. 

    Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Kralik SF, Kupakul N, Wu IC, et al. Neuroradiology. January 2019. 

    Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations. Puls HT, Anderst JD, Bettenhausen JL, et al. Pediatrics. February 2019. 

    A case of broken bones and systems: The threat of irresponsible testimony. Shur N. American Journal of Medical Genetics. January 2019. 

    Estimating the probability of abusive head trauma after abuse evaluation. Kymel KP, Wang M, Chinchilli VM, et all. Child Abuse & Neglect. February 2019. 

    Patterened Bruises from Abusive Screening. Petska H, Frasier LD, Livingston N, et al. Pediatric Emergency Care. January 2019. 

    Parasagittal vertex clots on head CT in infants with subdural hemorrhages as a predictor for abusive head trauma. Ronning MM, Carolan PL, Cutler GJ, Patterson RJ. Pediatric Radiology. December 2018. 

    Brain injury biomechanics and abusive head trauma. Castellani RJ and Schmidt CJ. Journal of Forensic Science and Medicine. 2018. 

    Childhood Falls with Occpital Impacts. Atkinson N, Rijn RR, Starling SP. Pediatric Emergency Care. December 2018. 

    The neuroimaging mimics of abusive head trauma. Mankad K, Chhabda S, Lim W, et al. Journal of Paediatric Neurology. 2018

    The medical and social outcomes in 2016 of infants who were victims of shaken baby syndrome between 2005 and 2013. Antoniette J, Resseguier N, Dubus J-C, et al. Archives de Pédiatrie. December 2018. 

    The detection of significant fractures in suspected infant abuse. Raynor E, Konala R, and Freemont A. Forensic and Legal Medicine. Nov. 2018. 

    Preventing Maltreatment of Children. Runyan DK. JAMA. Nov. 2018. 

    Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas. Gunda D, Cornwell BO, Dahmoush HM. et al. Radiographics. November 2018. 

    Frequencies and occurrences of violence prior to a diagnosis of shaking. Anne LV and Chevignard M. Annals of Physical and Rehabilitation Medicine. July 2018. 

    Skeletal Survey Yield in Young Children with Femur Fractures. Cornell EM and Powell EC. The Journal of Emergency Medicine. Oct. 2018.

    Pediatric traumatic brain injury and ocular injury. Gise R, Truong T, Poulsen DM, et al. The Journal of Emergency Medicine. Oct. 2018. 

    Neurosurgical aspects of abusive head trauma management in children: a review for the training neurosurgeon. Fitzpatrick S and Leach P. British Journal of Neurosurgery. Oct. 2018. 

    Usefulness of 3-D computed tomography for diagnosis of abusive head trauma. Zensho K, Yamamoto H, Tsukahara K. Pediatrics International. Sept. 2018. 

     Dating of Traumatic Brain Injury in Forensic Cases Using Immunohistochemical Markers (I): Neurofilaments and β-Amyloid Precursor Protein. Romero Tirado MLA, Blanco Pampin JM, Gallego Gomez R, Forensic Medicine and Pathology. Sept. 2018. 

    Flawed Swedish study on traumatic shaking is already being used by defence lawyers and its findings must be ignored. Laurent-Vannier A, Adamsbaum C, Raul JS, et al. Acta Paediatrica. Sept. 2018. 

    Prevalence, Patterns, and Clinical Relevance of Hypoxic-Ischemic Injuries in Children Exposed to Abusive Head Trauma. Orru' E, Huisman TAGM, and Izbudak I. Journal of Neuroimaging. August 2018. 

    Advanced Cervical Spine Imaging in Abusive Head Trauma: An Update on Recent Literature and Future Directions. Henry MK and Wood JN. Academic Pediatrics. Sept-Oct 2018. 

    Eight-year outcome of implementation of abusive head trauma prevention. Barr RG, Barr M, Rajabali F, et al. Child Abuse & Neglect: October 2018. 

    Racial and Ethic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. July 2018. 

    The Eye Examination in the Evaluation of Child Abuse. Christian CW and Levin AV. Pediatrics. July 2018. 

    Development of a Model of Hemispheric Hypodensity ("Big Black Brain"). Costine-Bartelle B, McGuone D, Price G. et al Journal of Neurotrauma. July 2018. 

    Pathology of Permiacular Folds due to Vitreoretinal Traction in Abusive Head Trauma. Abed Alnabi W, Tang GJ, Eagle RC, et al. RETINA. July 2018. 

    The Big Black Brain: Subdural Hemorrhage with Hemispheric Swelling and Low Attenuation. Luyet FM, Feldman KW, Knox BL. Journal of Child & Adolescent Trauma. June 2018. 

    Factors influencing child protection professionals' decision-making and multidiscliplinary collaboration in suspected abusive head trauma cases: A qualitative study. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. August 2018 

    Acceptablity of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. July 2018. 

    Combatting misinformation about abusive head trauma: AAP endorses new report. Narang SK. AAP News & Journals. June 2018. 

    Shaken baby syndrome is real. Strouse PJ. Pediatric Radiology. May 2018. 

    Pediatric Abusive Head Trauma (Shaken Baby Syndrome). Joyce T and Huecker MR. StatPearls. May 2018 (updated). 

    Consensus statement on abusive head trauma in infants and young children. Choudhary AK, Servaes S, Slovis TL, et al. Pediatric Radiology. May 2018 [epub ahead of print]. 

    A Cost Analysis of a Validated Screening Tool for Pediatric Abusive Head Trauma. Cohrs AC, Agbese E, Leslie DL, Hymel KP. Journal of Child and Family Studies. March 2018. 

    Relevance of Abusive Head Trauma to Intracranial Hemorrhages and Bleeding Disorders. Anderst JD, Carpenter SL, Presley R. et al. Pediatrics. April 2018. 

    External Validation of the PediBIRN Clinical Prediction Rule for Abusive Head Trauma. Pfeiffer H, Smith A, Kemp AM, et al. Pediatrics. April 2018. 

    Impact sites representing potential bruising locations associated with bed falls in children. Dsouza R and Bertocci G. Forensic Science International. May 2018 [epub ahead of print]

    When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants. Chen M, Barr RG, Miller E, et al. Infant Behavior and Development. March 2018. 

    Racial and Ethnic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. March 2018. 

    Cervical Spine Imaging and Injuries in Young Children with Non-Motor Vehicle Crash-Associated Traumatic Brain Injury. Henry KM, French B, Feudtner, C, et al. Pediatric Emergency Care. Feb. 2018 [Epub ahead of print]

    Distinguishing child abuse fractures from rickets. Oestreich AE. Pediatric Radiology. March 2018. 

    A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment. Ghanem MAH, Moustafa TA, Megahed HM, et al. Journal of Forensic and Legal Medicine. Feb. 2018. 

    Nonaccidental injury presenting as unilateral Retinal Detachment in two infants. Sornalingam K, Borman AD, and Ashworth J. Journal of American Association for Pediatric Ophthalmology and Strabismus. Feb. 2018. 

    A systematic autopsy survey of human infant bridging veins. Chesire EC, Malcomson RDG, Sun P, et al. International Journal of Legal Medicine. March 2018. 

    Fracture Patterns Differ Between Osteogenesis Imperfecta and Routine Pediatric Fractures. Peddada KV, Sullivan BT, Margalit A, et al. Journal of Pediatric Orthopaedics. January 2018 [epub ahead of print]. 

    Benign extracerebral fluid collection complicated by subdural hematoma and fluid collection: clinical characteristics and management. Lee HC, Chong A, Lee JY, et al. Child's Nervous System. February 2018. 

    Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma. Baerg J, Thirumoorthi A, Hazboun R, et al. Journal of Surgical Research. November 2017. 

    Retinal haemorrhage in infants with pertussis. Raoof N, Pereira S, Dai S, Neutze J, Grant CC, Kelly P. BMJ: Archives of Disease in Childhood. December 2017 [epub ahead of print]

    Pathophysiological and behavioral deficits in developing mice following rotational acceleration-deceleration traumatic brain injury. Wang G, Zhang XP, Gao Z, et al. Disease Models and Mechanisms. November 2017. 

    Development of a finite-element eye model to investigate retinal hemorrhages in shaken baby syndrome. Nadarasa J, Deck C, Meyer F, et al. Biomechanics and Modeling in Mechanobiology. December 2017. 

    Predictors of long-term neurological outcomes in non-accidental head injury. Chong CF, Misra SL, Escardo-Paton JA, Dai S. Eye. December 2017 [Epub ahead of print] 

    A Retrospective Study of Cervicla Spine MRI Findings in Children with Abusive Head Trauma. Governale LS, Brink FW, Pluta CP, et al. Pediatric Neurosurgery. December 2017. 

    Evaluations for abuse in young children with subudral hemorrhages: findings based on symptom severity and benign enlargment of the subarachnoid spaces. Hansen JB, Frazier T, Moffat M, et al. Journal of Neurosurgery: Pediatrics. November 2017. 

    Abusive Head Trauma and Mortality - An Analysis From an International Comparative Effectiveness Study of Children With Severe Traumatic Brain Injury. Miller Ferguson N, Sarnaik A, Miles D, et al. Critical Care Medicine. August 2017. 

    Inter-rater reliability of physical abuse determinations in young children with fractures. Buesser KE, Leventhal JM, Gaither JR, et al. Child Abuse & Neglect. October 2017. [Epub ahead of print]

    Throwing the baby out with the bath water - response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Saunders D, Raissaki M, Servaes S, et al. Pediatric Radiology. August 2017. 

    Lifetime Cost of Abusive Head Trauma at Ages 0-4, USA. Miller TR, Steinbeigle R, et al. Previ Sci. July 2017.

    Ocular Manifestations of Child Abuse. Warner N, McCans KM, Levin AV. The Eye in Pediatric Systemic Disease. June 2017. 

    In Vivo Demonstration of Traumatic Rupture of the Bridging Veins in Abusive Head Trauma. Zuccoli G, Khan AS, Panigrahy A, Tamber MS. Pediatric Neurology. April 2017.

    Pediatric abusive head trauma and stroke. Khan NR, Fraser BD, Nguyen V, et al. Journal of Neurosurgery: Pediatrics. June 2017. 

    Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation. Jenny CA, Bertocci G, Fukuda T, et al. Journal of Neurotrauma. April 2017. 

    The importance of optic nerve sheath hemorrhage as a postmortem finding in cases of fatal abusive head trauma: a 13-year study in a tertiary hospital. Puanglumyai S, Lekawanvijit S. Forensic Science International. April 2017. 

    Development and Validation of a Physical Model to Investigate the Biomechanics of Infant Head Injury. Jones M, Darwall D, Khalid G, et al. Forensics Science International. April 2017. 

    Photographic assessment of retinal hemorrhages in infant head injury: the Childhood Hemorrhagic Retinopathy Study. Bhardwaj G, Jacobs MB, Martin FJ, et al. Journal of America Association for Pediatric Ophthalmology and Strabismus. February 2017. 

    Derivation and Validation of a Serum Biomarker Panel to Identify Infants with Acute Intracranial Hemorrhage. Berger RP, Pak BJ, Kolesnikova MD. JAMA Pediatrics. April 2017 [Epub ahead of print].  

    Cervical spine imaging for young children with inflicted trauma: Expanding the injury pattern. Baerg J, Thirumoorthi A, Vannix R. et al. Journal of Pediatric Surgery. January 2017 [Epub ahead of print]. 

    Expert Witness Participation in Civil and Criminal Proceedings. Narang SK, Paul SR. Pediatrics. February 2017. 

    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. Offiah AC, Servaes S, Adamsbaum CS, et al. Pediatric Radiology. February 2017. 

    Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma. Kralik SF, Yasrebi M, Supakul N, et al. American Journal of Neuroradiology. February 2017. [Epub ahead of print]

    Prevention of Pediatric Abusive Head Trauma: Time to Rethink Interventions and Reframe Messages. Leventhal JM, Asnes AG, Bechtel K. JAMA Pediatrics. January 2017. 

    Association of a Postnatal Parent Education Program for Abusive Head Trauma With Subsequent Pediatric Abusive Head Trauma Hospitalizaton Rates. Dias MS, Rottmund CM, Cappos KM. JAMA Pediatrics. January 2017.

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. January 2017.

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 2: axial skeleton and differential diagnoses. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. Dec 2016.  

    Evaluation of the Hypothesis that Choking/ALTE May Mimic Abusive Head Trauma. Hansen JB, Frazier T, Moffat M, Zinkus T, Anderst JD. Academic Pediatrics. Dec. 2016. [Epub ahead of print]

    Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review. Laterza Lopes NR, de Albuquerque Williams LC. Trauma, Violence, & Abuse. Nov 2016.

    Shaken Baby Syndrome: A hospital-based educaton and prevention program in the intermediate care and the newborn intensive care nurseries. Lopez-Bushnell K, Torrez D, Robertson JV, Torrez C, Strickler L. Journal of Neonatal Nursing. Oct 2016.

    Skin Lesions and Other Associated Findings in Children with Abusive Head Trauma. Luyet FM, Wipperfurth J, Palm A, Knox BL. Journal of Family Violence. Oct 2016. 

    Ophthalmologic Concerns in Abusive Head Trauma. Levin AL, Luyet FM, Knox BL. Journal of Family Violence. Sept 2016. 

    Subdural Hematoma Rebleeding in Relation to Abusive Head Trauma. Knox BL, Rorke-Adams LB, Luyet FM. Journal of Family Violence. Sept 2016.

    Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes. Sariaslan A, Sharp DJ, D'Onofrio BM, Larsson H, Fazel S. PLoS Med. August 2016. 

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. August 2016.  

    Acceptance of Shaken Baby Syndrome and Abusive Head Trauma as Medical Diagnoses. Narang SK, Estrada C, Greenberg S, Lindberg DM. Pediatrics. July 2016. [Epub ahead of print]

    Abusive head trauma: an epidemiological and cost analysis. Boop S, Axente M, Weatherford B, Klimo P Jr. J Neurosurg Pediatr. July 2016 [Epub ahead of print]

    Accuracy of the history of injury obtained from the caregiver in infantile head trauma. Amagasa S, Matsui H, Tsuji S, Moriya T, Kinoshita K. Am J Emerg Med. June 2016. [Epub ahead of print]

    The classic metaphyseal lesion and traumatic injury. Thackeray JD, Wannemacher J, Adler BH, Lindberg DM. Pediatr Radiol. July 2016. 

    Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Berger RP, Fromkin J, Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Pediatrics. July 2016. 

    Fatal Abusive Head Trauma Among Children Aged <5 years - United States, 1999-2014. Spies EL, Klevens J. MMWR Morb Mortal Wkly Rep. May 2016. 

    Preventing Shaken Baby Syndrome: Evaluation of a Multiple-Setting Program. Stoltz HE, Brandon DJ, Wallace HS, Tucker EA. Journal of Family Issues. May 2016 [Epub ahead of print]

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. April 2016 [Epub ahead of print]

    The natural history of retinal hemorrhage in pediatric head trauma. Binenbaum G, Chen W, Huang J, Ying GS, Forbes BJ. J AAPOS. April 2016. 

    Paid family leave's effect on hospital admissions for pediatric abusive head trauma. Klevens J, Luo F, Xu L, Peterson C, Latzman NE. Inj Prev. February 2016. [Epub ahead of print]

    Hospital Variation in Cervical Spine Imaging of Young Children with Traumatic Brain Injury. Henry MK, Zonfrillo MR, French B, Song L, Feudtner C, Wood JN. Acad Pediatr. February 2016. [Epub ahead of print]

    A statewide nurse training program for a hospital based infant abusive head trauma prevention program. Nocera M, Shanahan M, Murphy RA, Sullivan KM, Barr M, Price J, Zolotor A. Nurse Educ Pract. January 2016.

    Pediatric Ophthalmologists' Experiences With Abusive Head Trauma. Sussenbach EC, Siatkowski RM, Ding K, Yanovitch TL. J Pediatr Ophthalmol Strabismus. January 2016.

    Neuroimaging differential diagnoses to abusive head trauma. Girard N, Brunel H, Dory-Lautrec P, Chabrol B. Pediatr Radiol. December 2015. [Epub ahead of print]

    Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina. Zolotor AJ, Runyan DK, Shanahan M, Durrance CP, Nocera M, Sullivan K, Klevens J, Murphy R, Barr M, Barr RG. JAMA Pediatr. December 2015.

    An evidence-based method for targeting an abusive head trauma prevention media campaign and its evaluation. Stewart TC, Gilliland J, Parry NG, Fraser DD. J Trauma Acute Care Surg. November 2015.

    Development of a screening MRI for infants at risk for abusive head trauma. Flom L, Fromkin J, Panigrahy A, Tyler-Kabara E, Berger RP. Pediatr Radiol. November 2015. [Epub ahead of print]

    Abusive head trauma: two case reports. Kanık A, İnce OT, Yeşiloğlu Ş, Eliaçık K, Bakiler AR. Turk Pediatri Ars. September 2015.

    Validation of a Prediction Tool for Abusive Head Trauma. Cowley LE, Morris CB, Maguire SA, Farewell DM, Kemp AM. Pediatrics. August 2015.

    Outcomes and factors associated with infant abusive head trauma in the US. Nuño M, Pelissier L, Varshneya K, Adamo MA, Drazin D. J Neurosurg Pediatr. July 2015. [Epub ahead of print]

    Long-term outcome in a case of shaken baby syndrome. Bartschat S1, Richter C2, Stiller D2, Banschak S3. Med Sci Law. June 2015.

    The evaluation of suspected child physical abuse. Christian CW; Committee on Child Abuse and Neglect, American Academy of Pediatrics. Pediatrics. May 2015.

    A Daubert Analysis of Abusive Head Trauma/Shaken Baby Syndrome – Part II: An Examination of the Differential Diagnosis

    by Jocelyn Kearl

    Sandeep Narang, et al. Houston Journal of Health Law and Policy: 2013

    READ MORE

    Abusive head trauma: past, present, and future

    by Jocelyn Kearl

    Sandeep Narang and J. Clarke. Journal of Neurology: 2014

    READ MORE

    Understanding Abusive Head Trauma in Infants and Children

    by Jocelyn Kearl

    American Academy of Pediatrics: 2015

    READ MORE

    The eye examination in the evaluation of child abuse

    by Jocelyn Kearl

    Cindy W. Christian & Alex V. Levin, Pediatrics: 2018

    READ MORE

    Response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking

    by Jocelyn Kearl

    Saunders, et al. Pediatric Radiology 2017.

    READ MORE

    Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation

    by Jocelyn Kearl

    Carole Jenny, et al. Journal of Neurotrauma: 2017

    READ MORE

    Neuroimaging of abusive head trauma

    by Jocelyn Kearl

    Gary Hedlund & Lori Frasier. Forensic Science Med Pathology: 2009

    READ MORE

    The Supreme Court Screws up the Science: There is No Abusive Head Trauma/Shaken Baby Syndrome 'Scientific' Controversy

    by Jocelyn Kearl

    Joelle Moreno and Brian Holmgren. Utah Law Review. July 2016

    READ MORE

    Natural history of retinal hemorrhage in pediatric head trauma

    by Jocelyn Kearl

    Binenbaum G, et al. JAAPOS: 2016. 

    READ MORE

    The etiology and significance of fractures in infants and young children: a critical multidisciplinary review

    by Jocelyn Kearl

    Sabah Servaes, et al. Pediatric Radiology. 2016

    READ MORE

    Abusive head trauma: judicial admissions highlight violent and repetitive shaking

    by Jocelyn Kearl

    Catherine Adamsbaum, et al. Pediatrics: September 2010

    READ MORE

    Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

    by Jocelyn Kearl

    Ronald G. Barr. PNAS: 2012

    READ MORE

    A Daubert analysis of abusive head trauma/shaken baby syndrome

    by Jocelyn Kearl

    Sandeep Narang. Houston Journal of Health Law and Policy: 2011

    READ MORE

    Research

    by Jocelyn Kearl

    Articles Everyone Should Know

    These are some of the most relevant research articles about Shaken Baby Syndrome/Abusive Head Trauma that will aid a lay person wanting to learn more about this form of child abuse.

    Recent Research

    The list below contains the most recent research relevant to SBS/AHT published during the past few years. The list cites the article’s title, author(s), title of the periodical or book, publication date and a link to the abstract or full article (if available). 

     

    Brückenvenenverletzungen bei Schütteltrauma [Bridging vein injuries in shaken baby syndrome] Wittschieber, D., Muggenthaler, H., Mall, G, et al. The Radiologist. December 2020.

    Denialism Preserves Scientific Controversies: a Case Study of Abusive Head Trauma Research. Lynøe, N., & Eriksson, A. Journal of Controversies in Biomedical Research. December 2020.

    Trends in Abusive and Nonabusive Injury Hospitalizations in Young Children in Texas, 2004-2018. Cain CM, Mandell DJ, Thompson RR, et al. Child Maltreatment. December 2020. 

    Evaluating abusive head trauma in children < 5 years old: Risk factors and the importance of the social history. Notrica DM, Kirsch L, Misra S, et al. Journal of Pediatric Surgery. October 2020. 

    Head computed tomography in suspected physical abuse: time to rethink? Glenn K, Nickerson E, Bennett CV, et al. BMJ. October 2020. 

    Medicolegal issues in abusive head trauma for the pediatric neurosurgeon. Bass DI, Lee A, Browd SR, et al. Neurosurg Focus. November 2020. 

    Abusive head trauma: experience improves diagnosis. Porto L, Bartles MB, Zwaschka J, et al. Paediatric Neuroradiology. October 2020. 

    Occurrence of traumatic brain injury due to short falls with or without a witness by a nonrelative in children younger than 2 years. Amagasa S, Uematsu S, & Tsuji S. Journal of Neurosurgery. September 2020. 

    Skull fractures in abusive head trauma: a single centre experience and review of the literature. Sidpra J, ul Owase Jeelani N, Ong J, et al. Child's Nervous System. September 2020. 

    Identifying Maltreatment in Infants and Young Children Presenting with Fractures: Does Age Matter? Mitchell IC, Norat BJ, Auerbach M, et al. Academic Emergency Medicine. September 2020. 

    Catching the red eye: A retrospective review of factors associated with retinal hemorrhage in child physical abuse. Moody S, Casar AM, Jenkins T, et al. Journal of Pediatric Surgery. September 2020. 

    Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants. Eismann EA, Theuerling J, Cassedy A, Curry PA, Colliers T, & Makoroff K. Child Abuse & Neglect. October 2020. 

    Short term outcomes of children with abusive head trauma two years post injury: A retrospective study. Badger S, Waugh MC, Hancock J, Marks S, & Oakley K. Journal of Pediatric Rehabilitation Medicine. August 2020. 

    Are Complex Skull Fractures Indicative of Either Child Abuse or Major Trauma in the Era of 3-Dimensional Computed Tomography. Metz JB, Otjen JP, Perez F, et al. Pediatric Emergency Care. August 2020 [epub ahead of print]

    Identification of Abusive Head Trauma in High-Risk Infants: A Cost-Effectiveness Analysis. Norrbakhsh KA, Berger RP, & Smith JK. The Journal of Pediatrics. June 2020. 

    Intracranial Injury Among Children with Abuse-Related Long Bone Fractures. Chahla S & Ortega H. The Journal of Emergency Medicine. July 2020. 

    Abusive Head Trauma and a Delay in Presentation for Care. Kennedy JM, Ma J, Lyden E, & Haney SB. Pediatric Emergency Care. July 2020. 

    Pediatric Rib Fractures Identified by Chest Radiography. Ruest S, Kanaan G, Moore J, & Goldberg AP. Pediatric Emergency Care. May 2020. 

    Identifying Predictors of Physical Abuse Evaluation of Injured Infants. Eismann EA, Shapiro RA, Makoroff KL, et al. Pediatric Emergency Care. May 2020. 

    Determining the Tractional Forces on Vitreoretinal Interface Using Computer Simulation Model in Abusive Head Trauma. Suh DW, Song HH, Mozafari H, & Thoreson WB. Am J Ophthalmol. July 2020 [epub ahead of print]. 

    Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation*. Hendrix AD, Conway LK, & Baxter MA. Journal of Forensic Sciences. June 2020. 

    Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital. Loos MLHJ, Ahmed T, Bakx R, & van Rijn RR. Pediatric Surgery International. June 2020. 

    Cerebrospinal fluid interaction with cerebral cortext during pediatric abusive head trauma. Toma M, Dehesa-Baeza A, Chan-Akaley, et al. Journal of Pediatric Neurology. July 2020. 

    Disability and visual outcomes following suspected abusive head trauma in children under 2 years. Wright J, Painter S, Sujayeendra Kodagali S, et al. BMJ: Archives of Disease in Childhood.  July 2020. 

    Features of intracranial hemorrhage in cerebral venous thrombosis. Afifi K, Bellanger G, Buyck PJ, et al. Journal of Neurology. June 2020. 

    Incidence and Risk Factors for Abusive Head Trauma A Population-Based Study. Rebbe R, Mienko JA, & Martinson ML. Child Abuse Review. June 2020. 

    High Frequency of Previous Abuse and Missed Diagnoses Prior to Abusive Head Trauma: A Consecutive Case Series of 100 Forensic Examinations. Laurent-Vannier A, Bernard JY, & Chevignard M. Child Abuse Review. June 2020. 

    Abusive Head Trauma in Infants: Incidence and Detection of Prior Brain Injury. Sirmai N, Garside L, & Tzioumi D. Child Abuse Review. June 2020. 

    What Do Confessions Reveal about Abusive Head Trauma? A Systematic Review. Edwards GA, Maguire SA, Gaither JR, & Leventhal JM. Child Abuse Review. June 2020. 

    Impact of the Take 5 Safety Plan for Crying on the Occurrence of Abusive Head Trauma. Bechtel K, Gaither JR, & Leventhal JM. Child Abuse Review. April 2020. 

    Financial Impact of Abusive Head Trauma to Age 17. Steinbeigle R, Barr M, Barr RG, & Miller TR. Child Abuse Review. June 2020. 

    More data, more questions: No simple answer about which children should undergo screening neuroimaging for clinically occult abusive head trauma. Henry MK, Lindberg DM, & Wood J. Child Abuse & Neglect. September 2020 [epub ahead of print]

    Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review. Figueira Rodrigues Vieira G & Guedes Correa JF. Neuroradiology. June 2020. 

    Differences in Incidence and Case Fatality of Abusive Head Trauma. Nuño M, Shelley CD, Ugiliweneza B, et al. Child Abuse & Neglect. June 2020. 

    Descriptive data on intracranial hemorrhage related to fatal non-accidental head injury in a pediatric population. Delteil C. Kolopp M, Torrents J, et al. La Revue de Médecine Légale. May 2020. 

    Cerebrospinal Fluid Interaction with Cerebral Cortex during Pediatric Abusive Head Trauma. Toma M, Dehesa-Baeza A, Chan-Akaley R, et al. Journal of Pediatric Neurology. January 2020. 

    Abusive Head Trauma in Infants and Children. Narang SK, Fingarson A, Lukefahr J, and Council on Child Abuse a Neglect.  Pediatrics. March 2020. 

    Pediatric cervical spine injuries on CT: difference in accuracy of interpretations by pediatric versus non-pediatric radiologists. Hassan N, Butler C, DeCou J, et al. Emergency Radiology. April 2020. 

    Occult head injuries in infants evaluated for physical abuse. Henry MK, Feudtner C, Fortin K, Lindberg DM, Anderst JD, Berger RP, & Wood JN. Child Abuse & Neglect. May 2020. 

    Retinal and visual function in infants with non-accidental trauma and retinal hemorrhages. Kelly JP, Feldman K, Wright J, Ganti S, Metz JB, & Weiss A. Documenta Ophthalmologica. February 2020. 

    Risk Factors for Child Maltreatment Fatalities in a National Pediatric Inpatient Database. Kennedy JM, Lazortiz S, & Palusci VJ. Hospital Pediatrics. February 2020. 

    Predictors for Nonaccidental Trauma in Child with a Fracture - A National Inpatient Database Study. Zhao C, Starke M, Tompson J, & Sabharwal S. Journal of the American Academy of Orthopaedic Surgeons. February 2020. 

    Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Karmazyn B, Marine MB, Wanner MR, et al. Pediatric Radiology. January 2020. 

    Predicting abusive head trauma in children. Davies, F. Emergency Medicine Journal. doi: 10.1136/emermed-2019-209280

    Estimating the Relevance of Historical Red Flags in the Diagnosis of Abusive Head Trauma. Hymel KP, Lee G, Boos S, et al. The Journal of Pediatrics. 2020. 

    Validation of the PredAHT-2 prediction tool for abusive head trauma. Pfeiffer H, Cowley LE, Kemp AM, et al. Emergency Medicine Journal, BMJ. January 2020. 

    Characteristics of rib fractures in young abused children. Kriss S, Thompson A, Bertocci G, Currie M, & Martich V. Pediatric Radiology. January 2020. 

    Characteristics associated with spine injury on magnetic resonance imaging in children evaluated for abusive head trauma. Rabbitt AL, Kelly TG, Yan K, et al. Pediatric Radiology. January 2020. 

    Implementation of a brain injury screen MRI for infants at risk for abusive head trauma. Berger RP, Furtado AD, Flom LL, Fromkin JB, & Panigrahy A. Pediatric Radiology. January 2020. 

    Neonatal shaking brain injury changes psychological stress-induced neuronal activity in adult male rats. Ueda S, Yamaguchi T, & Ehara A. Neuroscience Letters. January 2020. 

    Memorandum Opinion and Order on the United States' Motion in Limine for Daubert Ruling Regarding the Admissibility and Scope of Defendant's Proposed Expert Witness. United States District Court for the District of New Mexico. December 2019

    Inequities in Pediatric Abusive Head Trauma According to Neighborhood Social and Material Deprivation: A Population-level Study in British Columbia, Canada. Beaulieu E, Jiang A, Zheng A, et al. Journal of Child Maltreatment. December 2019. 

    Paediatric abusive head trauma in the emergency department: A multicentre prospective cohort study. Babl FE, Pfeiffer H, Kelly P, et al. Journal of Paediatrics and Child Health. December 2019.  

    Long-term visual outcomes following abusive head trauma with retinal hemorrrhage. Weldy, E., Shimoda, A., Patnaik, J. et al. Journal of American Association for Pediatric Ophthalmology and Strabismus. December 2019. 

    MRI Findings in Pediatric Abusive Head Trauma: A Review. Orman G, Kralik SF, Meoded A, et al. Journal of Neuroimaging. November 2019. 

    Growth recovery lines: a specific indicator of child abuse and neglect? Spiller LR, Kellogg ND, Mercado-Deane MG, et al. Pediatric Radiology. September 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Child Neurology. June 2019. 

    Nonaccidental Trauma is an Independent Risk Factor for Mortality Among Injured Infants. Delaplain PT, Grigorian A, Won E, et al. Pediatric Emergency Care. August 2019. 

    Identifying Child Abuse Fatalities During Infancy. The American Academy of Pediatrics. Pediatrics. August 2019. 

    National Risk Factors for Child Maltreatment after Trauma: Failure to Prevent. Parreco J, Quiroz HJ, Willobee BA, et al. The American Surgeon. July 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Children Neurology. June 2019. 

    The "New Science" of Abusive Head Trauma. Lindberg D, Dubowitz H, Alexander RC, & Reece, RM. International Journal of Child Maltreatment: Research, Policy and Practice. July 2019. 

    Every child, every time: hospital-wide child abuse screening increases awareness and state reporting. Dudas L, Petrohoy G, Esernio-Jenssen D, et al. Pediatric Surgery Interational. July 2019. 

    Prevalence of metaphyseal injury and its mimickers in otherwise healthy children under two years of age. Eide P, Djuve A, Myklebust R. et al. Pediatric Radiology. May 2019. 

    Cerebellar lesions in pediatric abusive head trauma. Haas-Lude K, Roulet-Perez E, Döbler-Neumann M, et al. European Journal of Paediatric Neurology. May 2019. 

    Frequency of macroscopic intradural hemorrhage with and without subdural hemorrhages in early childhood autopsies. Cheshire EC, Biggs MJP, Hollingbury FE, et al. Forensic Science, Medicine, and Pathology. June 2019. 

    Abusive head trauma, healthcare, and childhood professionals' lack of knowledge is detrimental to the child's interest. Laurent-Vannier A & Chevignard M. Archives de Pediatrie. May 2019. 

    Infant skull fracture risk for low height falls. Majiaghamemar M, Lan IS, Christian C, Coats B, Margulies SS. International Journal of Legal Medicine. May 2019. 

    Classic Metaphyseal Lesions among Victims of Abuse. Adamsbaum C, de Boissieu P, Teglas JP, et al. Pediatrics. April 2019. 

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Characteristics that distinguish abusive from nonabusive cases of sudden unexpected infant deaths. Bechtel K, Derbyshire M, Gaither JR, Leventhal JM. Pediatric Emergency Care. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part II: a systematic review of mathematical and physical models Part II: a systematic review of mathematical and physical models. van Zandwijk JP, Vester MEM, Bilo RA, van Rijn RR, Loeve AJ. Forensic Science, Medicine and Pathology. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part I: A systematic review of animal models Part I: A systematic review of animal models. Vester MEM, Bilo RAC, Loeve AJ, van Rijn RR, van Zandwijk JP. Forensic Science, Medicine and Pathology. March 2019. 

    Prevalence of Abuse Among Young Children With Rib Fractures. Paine CW, Fakeye O, Christian CW, and Wood JN. Pediatric Emergency Care. February 2019. 

    Age-Related Mortality in Abusive Head Trauma. Nuño M, Ugiliweneza B, Bardini R, et al. The Journal of Trauma and Acute Care Surgery. March 2019. [epub ahead of print]

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Consensus statement on abusive head trauma: additional endorsements. Choudhary AK, Suarez PD, Binenbaum G, et al. Pediatric Radiology. March 2019. 

    Early Recognition of Physical Abuse: Bridging the Gap between Knowledge and Practice. Berger R and Lindberg DM. Pediatrics. January 2019. 

    Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Kralik SF, Kupakul N, Wu IC, et al. Neuroradiology. January 2019. 

    Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations. Puls HT, Anderst JD, Bettenhausen JL, et al. Pediatrics. February 2019. 

    A case of broken bones and systems: The threat of irresponsible testimony. Shur N. American Journal of Medical Genetics. January 2019. 

    Estimating the probability of abusive head trauma after abuse evaluation. Kymel KP, Wang M, Chinchilli VM, et all. Child Abuse & Neglect. February 2019. 

    Patterened Bruises from Abusive Screening. Petska H, Frasier LD, Livingston N, et al. Pediatric Emergency Care. January 2019. 

    Parasagittal vertex clots on head CT in infants with subdural hemorrhages as a predictor for abusive head trauma. Ronning MM, Carolan PL, Cutler GJ, Patterson RJ. Pediatric Radiology. December 2018. 

    Brain injury biomechanics and abusive head trauma. Castellani RJ and Schmidt CJ. Journal of Forensic Science and Medicine. 2018. 

    Childhood Falls with Occpital Impacts. Atkinson N, Rijn RR, Starling SP. Pediatric Emergency Care. December 2018. 

    The neuroimaging mimics of abusive head trauma. Mankad K, Chhabda S, Lim W, et al. Journal of Paediatric Neurology. 2018

    The medical and social outcomes in 2016 of infants who were victims of shaken baby syndrome between 2005 and 2013. Antoniette J, Resseguier N, Dubus J-C, et al. Archives de Pédiatrie. December 2018. 

    The detection of significant fractures in suspected infant abuse. Raynor E, Konala R, and Freemont A. Forensic and Legal Medicine. Nov. 2018. 

    Preventing Maltreatment of Children. Runyan DK. JAMA. Nov. 2018. 

    Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas. Gunda D, Cornwell BO, Dahmoush HM. et al. Radiographics. November 2018. 

    Frequencies and occurrences of violence prior to a diagnosis of shaking. Anne LV and Chevignard M. Annals of Physical and Rehabilitation Medicine. July 2018. 

    Skeletal Survey Yield in Young Children with Femur Fractures. Cornell EM and Powell EC. The Journal of Emergency Medicine. Oct. 2018.

    Pediatric traumatic brain injury and ocular injury. Gise R, Truong T, Poulsen DM, et al. The Journal of Emergency Medicine. Oct. 2018. 

    Neurosurgical aspects of abusive head trauma management in children: a review for the training neurosurgeon. Fitzpatrick S and Leach P. British Journal of Neurosurgery. Oct. 2018. 

    Usefulness of 3-D computed tomography for diagnosis of abusive head trauma. Zensho K, Yamamoto H, Tsukahara K. Pediatrics International. Sept. 2018. 

     Dating of Traumatic Brain Injury in Forensic Cases Using Immunohistochemical Markers (I): Neurofilaments and β-Amyloid Precursor Protein. Romero Tirado MLA, Blanco Pampin JM, Gallego Gomez R, Forensic Medicine and Pathology. Sept. 2018. 

    Flawed Swedish study on traumatic shaking is already being used by defence lawyers and its findings must be ignored. Laurent-Vannier A, Adamsbaum C, Raul JS, et al. Acta Paediatrica. Sept. 2018. 

    Prevalence, Patterns, and Clinical Relevance of Hypoxic-Ischemic Injuries in Children Exposed to Abusive Head Trauma. Orru' E, Huisman TAGM, and Izbudak I. Journal of Neuroimaging. August 2018. 

    Advanced Cervical Spine Imaging in Abusive Head Trauma: An Update on Recent Literature and Future Directions. Henry MK and Wood JN. Academic Pediatrics. Sept-Oct 2018. 

    Eight-year outcome of implementation of abusive head trauma prevention. Barr RG, Barr M, Rajabali F, et al. Child Abuse & Neglect: October 2018. 

    Racial and Ethic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. July 2018. 

    The Eye Examination in the Evaluation of Child Abuse. Christian CW and Levin AV. Pediatrics. July 2018. 

    Development of a Model of Hemispheric Hypodensity ("Big Black Brain"). Costine-Bartelle B, McGuone D, Price G. et al Journal of Neurotrauma. July 2018. 

    Pathology of Permiacular Folds due to Vitreoretinal Traction in Abusive Head Trauma. Abed Alnabi W, Tang GJ, Eagle RC, et al. RETINA. July 2018. 

    The Big Black Brain: Subdural Hemorrhage with Hemispheric Swelling and Low Attenuation. Luyet FM, Feldman KW, Knox BL. Journal of Child & Adolescent Trauma. June 2018. 

    Factors influencing child protection professionals' decision-making and multidiscliplinary collaboration in suspected abusive head trauma cases: A qualitative study. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. August 2018 

    Acceptablity of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. July 2018. 

    Combatting misinformation about abusive head trauma: AAP endorses new report. Narang SK. AAP News & Journals. June 2018. 

    Shaken baby syndrome is real. Strouse PJ. Pediatric Radiology. May 2018. 

    Pediatric Abusive Head Trauma (Shaken Baby Syndrome). Joyce T and Huecker MR. StatPearls. May 2018 (updated). 

    Consensus statement on abusive head trauma in infants and young children. Choudhary AK, Servaes S, Slovis TL, et al. Pediatric Radiology. May 2018 [epub ahead of print]. 

    A Cost Analysis of a Validated Screening Tool for Pediatric Abusive Head Trauma. Cohrs AC, Agbese E, Leslie DL, Hymel KP. Journal of Child and Family Studies. March 2018. 

    Relevance of Abusive Head Trauma to Intracranial Hemorrhages and Bleeding Disorders. Anderst JD, Carpenter SL, Presley R. et al. Pediatrics. April 2018. 

    External Validation of the PediBIRN Clinical Prediction Rule for Abusive Head Trauma. Pfeiffer H, Smith A, Kemp AM, et al. Pediatrics. April 2018. 

    Impact sites representing potential bruising locations associated with bed falls in children. Dsouza R and Bertocci G. Forensic Science International. May 2018 [epub ahead of print]

    When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants. Chen M, Barr RG, Miller E, et al. Infant Behavior and Development. March 2018. 

    Racial and Ethnic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. March 2018. 

    Cervical Spine Imaging and Injuries in Young Children with Non-Motor Vehicle Crash-Associated Traumatic Brain Injury. Henry KM, French B, Feudtner, C, et al. Pediatric Emergency Care. Feb. 2018 [Epub ahead of print]

    Distinguishing child abuse fractures from rickets. Oestreich AE. Pediatric Radiology. March 2018. 

    A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment. Ghanem MAH, Moustafa TA, Megahed HM, et al. Journal of Forensic and Legal Medicine. Feb. 2018. 

    Nonaccidental injury presenting as unilateral Retinal Detachment in two infants. Sornalingam K, Borman AD, and Ashworth J. Journal of American Association for Pediatric Ophthalmology and Strabismus. Feb. 2018. 

    A systematic autopsy survey of human infant bridging veins. Chesire EC, Malcomson RDG, Sun P, et al. International Journal of Legal Medicine. March 2018. 

    Fracture Patterns Differ Between Osteogenesis Imperfecta and Routine Pediatric Fractures. Peddada KV, Sullivan BT, Margalit A, et al. Journal of Pediatric Orthopaedics. January 2018 [epub ahead of print]. 

    Benign extracerebral fluid collection complicated by subdural hematoma and fluid collection: clinical characteristics and management. Lee HC, Chong A, Lee JY, et al. Child's Nervous System. February 2018. 

    Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma. Baerg J, Thirumoorthi A, Hazboun R, et al. Journal of Surgical Research. November 2017. 

    Retinal haemorrhage in infants with pertussis. Raoof N, Pereira S, Dai S, Neutze J, Grant CC, Kelly P. BMJ: Archives of Disease in Childhood. December 2017 [epub ahead of print]

    Pathophysiological and behavioral deficits in developing mice following rotational acceleration-deceleration traumatic brain injury. Wang G, Zhang XP, Gao Z, et al. Disease Models and Mechanisms. November 2017. 

    Development of a finite-element eye model to investigate retinal hemorrhages in shaken baby syndrome. Nadarasa J, Deck C, Meyer F, et al. Biomechanics and Modeling in Mechanobiology. December 2017. 

    Predictors of long-term neurological outcomes in non-accidental head injury. Chong CF, Misra SL, Escardo-Paton JA, Dai S. Eye. December 2017 [Epub ahead of print] 

    A Retrospective Study of Cervicla Spine MRI Findings in Children with Abusive Head Trauma. Governale LS, Brink FW, Pluta CP, et al. Pediatric Neurosurgery. December 2017. 

    Evaluations for abuse in young children with subudral hemorrhages: findings based on symptom severity and benign enlargment of the subarachnoid spaces. Hansen JB, Frazier T, Moffat M, et al. Journal of Neurosurgery: Pediatrics. November 2017. 

    Abusive Head Trauma and Mortality - An Analysis From an International Comparative Effectiveness Study of Children With Severe Traumatic Brain Injury. Miller Ferguson N, Sarnaik A, Miles D, et al. Critical Care Medicine. August 2017. 

    Inter-rater reliability of physical abuse determinations in young children with fractures. Buesser KE, Leventhal JM, Gaither JR, et al. Child Abuse & Neglect. October 2017. [Epub ahead of print]

    Throwing the baby out with the bath water - response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Saunders D, Raissaki M, Servaes S, et al. Pediatric Radiology. August 2017. 

    Lifetime Cost of Abusive Head Trauma at Ages 0-4, USA. Miller TR, Steinbeigle R, et al. Previ Sci. July 2017.

    Ocular Manifestations of Child Abuse. Warner N, McCans KM, Levin AV. The Eye in Pediatric Systemic Disease. June 2017. 

    In Vivo Demonstration of Traumatic Rupture of the Bridging Veins in Abusive Head Trauma. Zuccoli G, Khan AS, Panigrahy A, Tamber MS. Pediatric Neurology. April 2017.

    Pediatric abusive head trauma and stroke. Khan NR, Fraser BD, Nguyen V, et al. Journal of Neurosurgery: Pediatrics. June 2017. 

    Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation. Jenny CA, Bertocci G, Fukuda T, et al. Journal of Neurotrauma. April 2017. 

    The importance of optic nerve sheath hemorrhage as a postmortem finding in cases of fatal abusive head trauma: a 13-year study in a tertiary hospital. Puanglumyai S, Lekawanvijit S. Forensic Science International. April 2017. 

    Development and Validation of a Physical Model to Investigate the Biomechanics of Infant Head Injury. Jones M, Darwall D, Khalid G, et al. Forensics Science International. April 2017. 

    Photographic assessment of retinal hemorrhages in infant head injury: the Childhood Hemorrhagic Retinopathy Study. Bhardwaj G, Jacobs MB, Martin FJ, et al. Journal of America Association for Pediatric Ophthalmology and Strabismus. February 2017. 

    Derivation and Validation of a Serum Biomarker Panel to Identify Infants with Acute Intracranial Hemorrhage. Berger RP, Pak BJ, Kolesnikova MD. JAMA Pediatrics. April 2017 [Epub ahead of print].  

    Cervical spine imaging for young children with inflicted trauma: Expanding the injury pattern. Baerg J, Thirumoorthi A, Vannix R. et al. Journal of Pediatric Surgery. January 2017 [Epub ahead of print]. 

    Expert Witness Participation in Civil and Criminal Proceedings. Narang SK, Paul SR. Pediatrics. February 2017. 

    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. Offiah AC, Servaes S, Adamsbaum CS, et al. Pediatric Radiology. February 2017. 

    Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma. Kralik SF, Yasrebi M, Supakul N, et al. American Journal of Neuroradiology. February 2017. [Epub ahead of print]

    Prevention of Pediatric Abusive Head Trauma: Time to Rethink Interventions and Reframe Messages. Leventhal JM, Asnes AG, Bechtel K. JAMA Pediatrics. January 2017. 

    Association of a Postnatal Parent Education Program for Abusive Head Trauma With Subsequent Pediatric Abusive Head Trauma Hospitalizaton Rates. Dias MS, Rottmund CM, Cappos KM. JAMA Pediatrics. January 2017.

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. January 2017.

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 2: axial skeleton and differential diagnoses. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. Dec 2016.  

    Evaluation of the Hypothesis that Choking/ALTE May Mimic Abusive Head Trauma. Hansen JB, Frazier T, Moffat M, Zinkus T, Anderst JD. Academic Pediatrics. Dec. 2016. [Epub ahead of print]

    Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review. Laterza Lopes NR, de Albuquerque Williams LC. Trauma, Violence, & Abuse. Nov 2016.

    Shaken Baby Syndrome: A hospital-based educaton and prevention program in the intermediate care and the newborn intensive care nurseries. Lopez-Bushnell K, Torrez D, Robertson JV, Torrez C, Strickler L. Journal of Neonatal Nursing. Oct 2016.

    Skin Lesions and Other Associated Findings in Children with Abusive Head Trauma. Luyet FM, Wipperfurth J, Palm A, Knox BL. Journal of Family Violence. Oct 2016. 

    Ophthalmologic Concerns in Abusive Head Trauma. Levin AL, Luyet FM, Knox BL. Journal of Family Violence. Sept 2016. 

    Subdural Hematoma Rebleeding in Relation to Abusive Head Trauma. Knox BL, Rorke-Adams LB, Luyet FM. Journal of Family Violence. Sept 2016.

    Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes. Sariaslan A, Sharp DJ, D'Onofrio BM, Larsson H, Fazel S. PLoS Med. August 2016. 

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. August 2016.  

    Acceptance of Shaken Baby Syndrome and Abusive Head Trauma as Medical Diagnoses. Narang SK, Estrada C, Greenberg S, Lindberg DM. Pediatrics. July 2016. [Epub ahead of print]

    Abusive head trauma: an epidemiological and cost analysis. Boop S, Axente M, Weatherford B, Klimo P Jr. J Neurosurg Pediatr. July 2016 [Epub ahead of print]

    Accuracy of the history of injury obtained from the caregiver in infantile head trauma. Amagasa S, Matsui H, Tsuji S, Moriya T, Kinoshita K. Am J Emerg Med. June 2016. [Epub ahead of print]

    The classic metaphyseal lesion and traumatic injury. Thackeray JD, Wannemacher J, Adler BH, Lindberg DM. Pediatr Radiol. July 2016. 

    Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Berger RP, Fromkin J, Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Pediatrics. July 2016. 

    Fatal Abusive Head Trauma Among Children Aged <5 years - United States, 1999-2014. Spies EL, Klevens J. MMWR Morb Mortal Wkly Rep. May 2016. 

    Preventing Shaken Baby Syndrome: Evaluation of a Multiple-Setting Program. Stoltz HE, Brandon DJ, Wallace HS, Tucker EA. Journal of Family Issues. May 2016 [Epub ahead of print]

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. April 2016 [Epub ahead of print]

    The natural history of retinal hemorrhage in pediatric head trauma. Binenbaum G, Chen W, Huang J, Ying GS, Forbes BJ. J AAPOS. April 2016. 

    Paid family leave's effect on hospital admissions for pediatric abusive head trauma. Klevens J, Luo F, Xu L, Peterson C, Latzman NE. Inj Prev. February 2016. [Epub ahead of print]

    Hospital Variation in Cervical Spine Imaging of Young Children with Traumatic Brain Injury. Henry MK, Zonfrillo MR, French B, Song L, Feudtner C, Wood JN. Acad Pediatr. February 2016. [Epub ahead of print]

    A statewide nurse training program for a hospital based infant abusive head trauma prevention program. Nocera M, Shanahan M, Murphy RA, Sullivan KM, Barr M, Price J, Zolotor A. Nurse Educ Pract. January 2016.

    Pediatric Ophthalmologists' Experiences With Abusive Head Trauma. Sussenbach EC, Siatkowski RM, Ding K, Yanovitch TL. J Pediatr Ophthalmol Strabismus. January 2016.

    Neuroimaging differential diagnoses to abusive head trauma. Girard N, Brunel H, Dory-Lautrec P, Chabrol B. Pediatr Radiol. December 2015. [Epub ahead of print]

    Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina. Zolotor AJ, Runyan DK, Shanahan M, Durrance CP, Nocera M, Sullivan K, Klevens J, Murphy R, Barr M, Barr RG. JAMA Pediatr. December 2015.

    An evidence-based method for targeting an abusive head trauma prevention media campaign and its evaluation. Stewart TC, Gilliland J, Parry NG, Fraser DD. J Trauma Acute Care Surg. November 2015.

    Development of a screening MRI for infants at risk for abusive head trauma. Flom L, Fromkin J, Panigrahy A, Tyler-Kabara E, Berger RP. Pediatr Radiol. November 2015. [Epub ahead of print]

    Abusive head trauma: two case reports. Kanık A, İnce OT, Yeşiloğlu Ş, Eliaçık K, Bakiler AR. Turk Pediatri Ars. September 2015.

    Validation of a Prediction Tool for Abusive Head Trauma. Cowley LE, Morris CB, Maguire SA, Farewell DM, Kemp AM. Pediatrics. August 2015.

    Outcomes and factors associated with infant abusive head trauma in the US. Nuño M, Pelissier L, Varshneya K, Adamo MA, Drazin D. J Neurosurg Pediatr. July 2015. [Epub ahead of print]

    Long-term outcome in a case of shaken baby syndrome. Bartschat S1, Richter C2, Stiller D2, Banschak S3. Med Sci Law. June 2015.

    The evaluation of suspected child physical abuse. Christian CW; Committee on Child Abuse and Neglect, American Academy of Pediatrics. Pediatrics. May 2015.

    A Daubert Analysis of Abusive Head Trauma/Shaken Baby Syndrome – Part II: An Examination of the Differential Diagnosis

    by Jocelyn Kearl

    Sandeep Narang, et al. Houston Journal of Health Law and Policy: 2013

    READ MORE

    Abusive head trauma: past, present, and future

    by Jocelyn Kearl

    Sandeep Narang and J. Clarke. Journal of Neurology: 2014

    READ MORE

    Understanding Abusive Head Trauma in Infants and Children

    by Jocelyn Kearl

    American Academy of Pediatrics: 2015

    READ MORE

    The eye examination in the evaluation of child abuse

    by Jocelyn Kearl

    Cindy W. Christian & Alex V. Levin, Pediatrics: 2018

    READ MORE

    Response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking

    by Jocelyn Kearl

    Saunders, et al. Pediatric Radiology 2017.

    READ MORE

    Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation

    by Jocelyn Kearl

    Carole Jenny, et al. Journal of Neurotrauma: 2017

    READ MORE

    Neuroimaging of abusive head trauma

    by Jocelyn Kearl

    Gary Hedlund & Lori Frasier. Forensic Science Med Pathology: 2009

    READ MORE

    The Supreme Court Screws up the Science: There is No Abusive Head Trauma/Shaken Baby Syndrome 'Scientific' Controversy

    by Jocelyn Kearl

    Joelle Moreno and Brian Holmgren. Utah Law Review. July 2016

    READ MORE

    Natural history of retinal hemorrhage in pediatric head trauma

    by Jocelyn Kearl

    Binenbaum G, et al. JAAPOS: 2016. 

    READ MORE

    The etiology and significance of fractures in infants and young children: a critical multidisciplinary review

    by Jocelyn Kearl

    Sabah Servaes, et al. Pediatric Radiology. 2016

    READ MORE

    Imaging of spinal injury in abusive head trauma: a retrospective

    by Jocelyn Kearl

    A.K. Choudary, et al. Pediatric Radiology: 2014

    READ MORE

    Mimics of child abuse: Can choking explain abusive head trauma?

    by Jocelyn Kearl

    George Edwards. Journal of Forensic Legal Medicine 2015

    READ MORE

    Recent Research

    The list below contains the most recent research relevant to SBS/AHT published during the past few years. The list cites the article’s title, author(s), title of the periodical or book, publication date and a link to the abstract or full article (if available). 

    2021

    2021

    2020

    2020

     

    Brückenvenenverletzungen bei Schütteltrauma [Bridging vein injuries in shaken baby syndrome] Wittschieber, D., Muggenthaler, H., Mall, G, et al. The Radiologist. December 2020.

    Denialism Preserves Scientific Controversies: a Case Study of Abusive Head Trauma Research. Lynøe, N., & Eriksson, A. Journal of Controversies in Biomedical Research. December 2020.

    Trends in Abusive and Nonabusive Injury Hospitalizations in Young Children in Texas, 2004-2018. Cain CM, Mandell DJ, Thompson RR, et al. Child Maltreatment. December 2020. 

    Evaluating abusive head trauma in children < 5 years old: Risk factors and the importance of the social history. Notrica DM, Kirsch L, Misra S, et al. Journal of Pediatric Surgery. October 2020. 

    Head computed tomography in suspected physical abuse: time to rethink? Glenn K, Nickerson E, Bennett CV, et al. BMJ. October 2020. 

    Medicolegal issues in abusive head trauma for the pediatric neurosurgeon. Bass DI, Lee A, Browd SR, et al. Neurosurg Focus. November 2020. 

    Abusive head trauma: experience improves diagnosis. Porto L, Bartles MB, Zwaschka J, et al. Paediatric Neuroradiology. October 2020. 

    Occurrence of traumatic brain injury due to short falls with or without a witness by a nonrelative in children younger than 2 years. Amagasa S, Uematsu S, & Tsuji S. Journal of Neurosurgery. September 2020. 

    Skull fractures in abusive head trauma: a single centre experience and review of the literature. Sidpra J, ul Owase Jeelani N, Ong J, et al. Child's Nervous System. September 2020. 

    Identifying Maltreatment in Infants and Young Children Presenting with Fractures: Does Age Matter? Mitchell IC, Norat BJ, Auerbach M, et al. Academic Emergency Medicine. September 2020. 

    Catching the red eye: A retrospective review of factors associated with retinal hemorrhage in child physical abuse. Moody S, Casar AM, Jenkins T, et al. Journal of Pediatric Surgery. September 2020. 

    Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants. Eismann EA, Theuerling J, Cassedy A, Curry PA, Colliers T, & Makoroff K. Child Abuse & Neglect. October 2020. 

    Short term outcomes of children with abusive head trauma two years post injury: A retrospective study. Badger S, Waugh MC, Hancock J, Marks S, & Oakley K. Journal of Pediatric Rehabilitation Medicine. August 2020. 

    Are Complex Skull Fractures Indicative of Either Child Abuse or Major Trauma in the Era of 3-Dimensional Computed Tomography. Metz JB, Otjen JP, Perez F, et al. Pediatric Emergency Care. August 2020 [epub ahead of print]

    Identification of Abusive Head Trauma in High-Risk Infants: A Cost-Effectiveness Analysis. Norrbakhsh KA, Berger RP, & Smith JK. The Journal of Pediatrics. June 2020. 

    Intracranial Injury Among Children with Abuse-Related Long Bone Fractures. Chahla S & Ortega H. The Journal of Emergency Medicine. July 2020. 

    Abusive Head Trauma and a Delay in Presentation for Care. Kennedy JM, Ma J, Lyden E, & Haney SB. Pediatric Emergency Care. July 2020. 

    Pediatric Rib Fractures Identified by Chest Radiography. Ruest S, Kanaan G, Moore J, & Goldberg AP. Pediatric Emergency Care. May 2020. 

    Identifying Predictors of Physical Abuse Evaluation of Injured Infants. Eismann EA, Shapiro RA, Makoroff KL, et al. Pediatric Emergency Care. May 2020. 

    Determining the Tractional Forces on Vitreoretinal Interface Using Computer Simulation Model in Abusive Head Trauma. Suh DW, Song HH, Mozafari H, & Thoreson WB. Am J Ophthalmol. July 2020 [epub ahead of print]. 

    Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation*. Hendrix AD, Conway LK, & Baxter MA. Journal of Forensic Sciences. June 2020. 

    Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital. Loos MLHJ, Ahmed T, Bakx R, & van Rijn RR. Pediatric Surgery International. June 2020. 

    Cerebrospinal fluid interaction with cerebral cortext during pediatric abusive head trauma. Toma M, Dehesa-Baeza A, Chan-Akaley, et al. Journal of Pediatric Neurology. July 2020. 

    Disability and visual outcomes following suspected abusive head trauma in children under 2 years. Wright J, Painter S, Sujayeendra Kodagali S, et al. BMJ: Archives of Disease in Childhood.  July 2020. 

    Features of intracranial hemorrhage in cerebral venous thrombosis. Afifi K, Bellanger G, Buyck PJ, et al. Journal of Neurology. June 2020. 

    Incidence and Risk Factors for Abusive Head Trauma A Population-Based Study. Rebbe R, Mienko JA, & Martinson ML. Child Abuse Review. June 2020. 

    High Frequency of Previous Abuse and Missed Diagnoses Prior to Abusive Head Trauma: A Consecutive Case Series of 100 Forensic Examinations. Laurent-Vannier A, Bernard JY, & Chevignard M. Child Abuse Review. June 2020. 

    Abusive Head Trauma in Infants: Incidence and Detection of Prior Brain Injury. Sirmai N, Garside L, & Tzioumi D. Child Abuse Review. June 2020. 

    What Do Confessions Reveal about Abusive Head Trauma? A Systematic Review. Edwards GA, Maguire SA, Gaither JR, & Leventhal JM. Child Abuse Review. June 2020. 

    Impact of the Take 5 Safety Plan for Crying on the Occurrence of Abusive Head Trauma. Bechtel K, Gaither JR, & Leventhal JM. Child Abuse Review. April 2020. 

    Financial Impact of Abusive Head Trauma to Age 17. Steinbeigle R, Barr M, Barr RG, & Miller TR. Child Abuse Review. June 2020. 

    More data, more questions: No simple answer about which children should undergo screening neuroimaging for clinically occult abusive head trauma. Henry MK, Lindberg DM, & Wood J. Child Abuse & Neglect. September 2020 [epub ahead of print]

    Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review. Figueira Rodrigues Vieira G & Guedes Correa JF. Neuroradiology. June 2020. 

    Differences in Incidence and Case Fatality of Abusive Head Trauma. Nuño M, Shelley CD, Ugiliweneza B, et al. Child Abuse & Neglect. June 2020. 

    Descriptive data on intracranial hemorrhage related to fatal non-accidental head injury in a pediatric population. Delteil C. Kolopp M, Torrents J, et al. La Revue de Médecine Légale. May 2020. 

    Cerebrospinal Fluid Interaction with Cerebral Cortex during Pediatric Abusive Head Trauma. Toma M, Dehesa-Baeza A, Chan-Akaley R, et al. Journal of Pediatric Neurology. January 2020. 

    Abusive Head Trauma in Infants and Children. Narang SK, Fingarson A, Lukefahr J, and Council on Child Abuse a Neglect.  Pediatrics. March 2020. 

    Pediatric cervical spine injuries on CT: difference in accuracy of interpretations by pediatric versus non-pediatric radiologists. Hassan N, Butler C, DeCou J, et al. Emergency Radiology. April 2020. 

    Occult head injuries in infants evaluated for physical abuse. Henry MK, Feudtner C, Fortin K, Lindberg DM, Anderst JD, Berger RP, & Wood JN. Child Abuse & Neglect. May 2020. 

    Retinal and visual function in infants with non-accidental trauma and retinal hemorrhages. Kelly JP, Feldman K, Wright J, Ganti S, Metz JB, & Weiss A. Documenta Ophthalmologica. February 2020. 

    Risk Factors for Child Maltreatment Fatalities in a National Pediatric Inpatient Database. Kennedy JM, Lazortiz S, & Palusci VJ. Hospital Pediatrics. February 2020. 

    Predictors for Nonaccidental Trauma in Child with a Fracture - A National Inpatient Database Study. Zhao C, Starke M, Tompson J, & Sabharwal S. Journal of the American Academy of Orthopaedic Surgeons. February 2020. 

    Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions. Karmazyn B, Marine MB, Wanner MR, et al. Pediatric Radiology. January 2020. 

    Predicting abusive head trauma in children. Davies, F. Emergency Medicine Journal. doi: 10.1136/emermed-2019-209280

    Estimating the Relevance of Historical Red Flags in the Diagnosis of Abusive Head Trauma. Hymel KP, Lee G, Boos S, et al. The Journal of Pediatrics. 2020. 

    Validation of the PredAHT-2 prediction tool for abusive head trauma. Pfeiffer H, Cowley LE, Kemp AM, et al. Emergency Medicine Journal, BMJ. January 2020. 

    Characteristics of rib fractures in young abused children. Kriss S, Thompson A, Bertocci G, Currie M, & Martich V. Pediatric Radiology. January 2020. 

    Characteristics associated with spine injury on magnetic resonance imaging in children evaluated for abusive head trauma. Rabbitt AL, Kelly TG, Yan K, et al. Pediatric Radiology. January 2020. 

    Implementation of a brain injury screen MRI for infants at risk for abusive head trauma. Berger RP, Furtado AD, Flom LL, Fromkin JB, & Panigrahy A. Pediatric Radiology. January 2020. 

    Neonatal shaking brain injury changes psychological stress-induced neuronal activity in adult male rats. Ueda S, Yamaguchi T, & Ehara A. Neuroscience Letters. January 2020. 

    2019

    2019

    Memorandum Opinion and Order on the United States' Motion in Limine for Daubert Ruling Regarding the Admissibility and Scope of Defendant's Proposed Expert Witness. United States District Court for the District of New Mexico. December 2019

    Inequities in Pediatric Abusive Head Trauma According to Neighborhood Social and Material Deprivation: A Population-level Study in British Columbia, Canada. Beaulieu E, Jiang A, Zheng A, et al. Journal of Child Maltreatment. December 2019. 

    Paediatric abusive head trauma in the emergency department: A multicentre prospective cohort study. Babl FE, Pfeiffer H, Kelly P, et al. Journal of Paediatrics and Child Health. December 2019.  

    Long-term visual outcomes following abusive head trauma with retinal hemorrrhage. Weldy, E., Shimoda, A., Patnaik, J. et al. Journal of American Association for Pediatric Ophthalmology and Strabismus. December 2019. 

    MRI Findings in Pediatric Abusive Head Trauma: A Review. Orman G, Kralik SF, Meoded A, et al. Journal of Neuroimaging. November 2019. 

    Growth recovery lines: a specific indicator of child abuse and neglect? Spiller LR, Kellogg ND, Mercado-Deane MG, et al. Pediatric Radiology. September 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Child Neurology. June 2019. 

    Nonaccidental Trauma is an Independent Risk Factor for Mortality Among Injured Infants. Delaplain PT, Grigorian A, Won E, et al. Pediatric Emergency Care. August 2019. 

    Identifying Child Abuse Fatalities During Infancy. The American Academy of Pediatrics. Pediatrics. August 2019. 

    National Risk Factors for Child Maltreatment after Trauma: Failure to Prevent. Parreco J, Quiroz HJ, Willobee BA, et al. The American Surgeon. July 2019. 

    Clinical Characteristics and Nonconvulsive Seizures in Young Children with Abusive Head Trauma. Oh A, Olson LD, & Chern JJ. Journal of Children Neurology. June 2019. 

    The "New Science" of Abusive Head Trauma. Lindberg D, Dubowitz H, Alexander RC, & Reece, RM. International Journal of Child Maltreatment: Research, Policy and Practice. July 2019. 

    Every child, every time: hospital-wide child abuse screening increases awareness and state reporting. Dudas L, Petrohoy G, Esernio-Jenssen D, et al. Pediatric Surgery Interational. July 2019. 

    Prevalence of metaphyseal injury and its mimickers in otherwise healthy children under two years of age. Eide P, Djuve A, Myklebust R. et al. Pediatric Radiology. May 2019. 

    Cerebellar lesions in pediatric abusive head trauma. Haas-Lude K, Roulet-Perez E, Döbler-Neumann M, et al. European Journal of Paediatric Neurology. May 2019. 

    Frequency of macroscopic intradural hemorrhage with and without subdural hemorrhages in early childhood autopsies. Cheshire EC, Biggs MJP, Hollingbury FE, et al. Forensic Science, Medicine, and Pathology. June 2019. 

    Abusive head trauma, healthcare, and childhood professionals' lack of knowledge is detrimental to the child's interest. Laurent-Vannier A & Chevignard M. Archives de Pediatrie. May 2019. 

    Infant skull fracture risk for low height falls. Majiaghamemar M, Lan IS, Christian C, Coats B, Margulies SS. International Journal of Legal Medicine. May 2019. 

    Classic Metaphyseal Lesions among Victims of Abuse. Adamsbaum C, de Boissieu P, Teglas JP, et al. Pediatrics. April 2019. 

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Characteristics that distinguish abusive from nonabusive cases of sudden unexpected infant deaths. Bechtel K, Derbyshire M, Gaither JR, Leventhal JM. Pediatric Emergency Care. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part II: a systematic review of mathematical and physical models Part II: a systematic review of mathematical and physical models. van Zandwijk JP, Vester MEM, Bilo RA, van Rijn RR, Loeve AJ. Forensic Science, Medicine and Pathology. February 2019. 

    Modeling of inflicted head injury by shaking trauma in children: what can we learn? Part I: A systematic review of animal models Part I: A systematic review of animal models. Vester MEM, Bilo RAC, Loeve AJ, van Rijn RR, van Zandwijk JP. Forensic Science, Medicine and Pathology. March 2019. 

    Prevalence of Abuse Among Young Children With Rib Fractures. Paine CW, Fakeye O, Christian CW, and Wood JN. Pediatric Emergency Care. February 2019. 

    Age-Related Mortality in Abusive Head Trauma. Nuño M, Ugiliweneza B, Bardini R, et al. The Journal of Trauma and Acute Care Surgery. March 2019. [epub ahead of print]

    Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study. Rolfes MC, Deyle DR, King KS, et al. Child Abuse & Neglect. May 2019. 

    Consensus statement on abusive head trauma: additional endorsements. Choudhary AK, Suarez PD, Binenbaum G, et al. Pediatric Radiology. March 2019. 

    Early Recognition of Physical Abuse: Bridging the Gap between Knowledge and Practice. Berger R and Lindberg DM. Pediatrics. January 2019. 

    Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Kralik SF, Kupakul N, Wu IC, et al. Neuroradiology. January 2019. 

    Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations. Puls HT, Anderst JD, Bettenhausen JL, et al. Pediatrics. February 2019. 

    A case of broken bones and systems: The threat of irresponsible testimony. Shur N. American Journal of Medical Genetics. January 2019. 

    Estimating the probability of abusive head trauma after abuse evaluation. Kymel KP, Wang M, Chinchilli VM, et all. Child Abuse & Neglect. February 2019. 

    Patterened Bruises from Abusive Screening. Petska H, Frasier LD, Livingston N, et al. Pediatric Emergency Care. January 2019. 

    2018

    2018

    Parasagittal vertex clots on head CT in infants with subdural hemorrhages as a predictor for abusive head trauma. Ronning MM, Carolan PL, Cutler GJ, Patterson RJ. Pediatric Radiology. December 2018. 

    Brain injury biomechanics and abusive head trauma. Castellani RJ and Schmidt CJ. Journal of Forensic Science and Medicine. 2018. 

    Childhood Falls with Occpital Impacts. Atkinson N, Rijn RR, Starling SP. Pediatric Emergency Care. December 2018. 

    The neuroimaging mimics of abusive head trauma. Mankad K, Chhabda S, Lim W, et al. Journal of Paediatric Neurology. 2018

    The medical and social outcomes in 2016 of infants who were victims of shaken baby syndrome between 2005 and 2013. Antoniette J, Resseguier N, Dubus J-C, et al. Archives de Pédiatrie. December 2018. 

    The detection of significant fractures in suspected infant abuse. Raynor E, Konala R, and Freemont A. Forensic and Legal Medicine. Nov. 2018. 

    Preventing Maltreatment of Children. Runyan DK. JAMA. Nov. 2018. 

    Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas. Gunda D, Cornwell BO, Dahmoush HM. et al. Radiographics. November 2018. 

    Frequencies and occurrences of violence prior to a diagnosis of shaking. Anne LV and Chevignard M. Annals of Physical and Rehabilitation Medicine. July 2018. 

    Skeletal Survey Yield in Young Children with Femur Fractures. Cornell EM and Powell EC. The Journal of Emergency Medicine. Oct. 2018.

    Pediatric traumatic brain injury and ocular injury. Gise R, Truong T, Poulsen DM, et al. The Journal of Emergency Medicine. Oct. 2018. 

    Neurosurgical aspects of abusive head trauma management in children: a review for the training neurosurgeon. Fitzpatrick S and Leach P. British Journal of Neurosurgery. Oct. 2018. 

    Usefulness of 3-D computed tomography for diagnosis of abusive head trauma. Zensho K, Yamamoto H, Tsukahara K. Pediatrics International. Sept. 2018. 

     Dating of Traumatic Brain Injury in Forensic Cases Using Immunohistochemical Markers (I): Neurofilaments and β-Amyloid Precursor Protein. Romero Tirado MLA, Blanco Pampin JM, Gallego Gomez R, Forensic Medicine and Pathology. Sept. 2018. 

    Flawed Swedish study on traumatic shaking is already being used by defence lawyers and its findings must be ignored. Laurent-Vannier A, Adamsbaum C, Raul JS, et al. Acta Paediatrica. Sept. 2018. 

    Prevalence, Patterns, and Clinical Relevance of Hypoxic-Ischemic Injuries in Children Exposed to Abusive Head Trauma. Orru' E, Huisman TAGM, and Izbudak I. Journal of Neuroimaging. August 2018. 

    Advanced Cervical Spine Imaging in Abusive Head Trauma: An Update on Recent Literature and Future Directions. Henry MK and Wood JN. Academic Pediatrics. Sept-Oct 2018. 

    Eight-year outcome of implementation of abusive head trauma prevention. Barr RG, Barr M, Rajabali F, et al. Child Abuse & Neglect: October 2018. 

    Racial and Ethic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. July 2018. 

    The Eye Examination in the Evaluation of Child Abuse. Christian CW and Levin AV. Pediatrics. July 2018. 

    Development of a Model of Hemispheric Hypodensity ("Big Black Brain"). Costine-Bartelle B, McGuone D, Price G. et al Journal of Neurotrauma. July 2018. 

    Pathology of Permiacular Folds due to Vitreoretinal Traction in Abusive Head Trauma. Abed Alnabi W, Tang GJ, Eagle RC, et al. RETINA. July 2018. 

    The Big Black Brain: Subdural Hemorrhage with Hemispheric Swelling and Low Attenuation. Luyet FM, Feldman KW, Knox BL. Journal of Child & Adolescent Trauma. June 2018. 

    Factors influencing child protection professionals' decision-making and multidiscliplinary collaboration in suspected abusive head trauma cases: A qualitative study. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. August 2018 

    Acceptablity of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals. Cowley LE, Maguire S, Farewell DM, et al. Child Abuse & Neglect. July 2018. 

    Combatting misinformation about abusive head trauma: AAP endorses new report. Narang SK. AAP News & Journals. June 2018. 

    Shaken baby syndrome is real. Strouse PJ. Pediatric Radiology. May 2018. 

    Pediatric Abusive Head Trauma (Shaken Baby Syndrome). Joyce T and Huecker MR. StatPearls. May 2018 (updated). 

    Consensus statement on abusive head trauma in infants and young children. Choudhary AK, Servaes S, Slovis TL, et al. Pediatric Radiology. May 2018 [epub ahead of print]. 

    A Cost Analysis of a Validated Screening Tool for Pediatric Abusive Head Trauma. Cohrs AC, Agbese E, Leslie DL, Hymel KP. Journal of Child and Family Studies. March 2018. 

    Relevance of Abusive Head Trauma to Intracranial Hemorrhages and Bleeding Disorders. Anderst JD, Carpenter SL, Presley R. et al. Pediatrics. April 2018. 

    External Validation of the PediBIRN Clinical Prediction Rule for Abusive Head Trauma. Pfeiffer H, Smith A, Kemp AM, et al. Pediatrics. April 2018. 

    Impact sites representing potential bruising locations associated with bed falls in children. Dsouza R and Bertocci G. Forensic Science International. May 2018 [epub ahead of print]

    When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants. Chen M, Barr RG, Miller E, et al. Infant Behavior and Development. March 2018. 

    Racial and Ethnic Disparities and Bias in the Evaluation and Reporting of Abusive Head Trauma. Hymel KP, Laskey AL, Crowell KR, et al. The Journal of Pediatrics. March 2018. 

    Cervical Spine Imaging and Injuries in Young Children with Non-Motor Vehicle Crash-Associated Traumatic Brain Injury. Henry KM, French B, Feudtner, C, et al. Pediatric Emergency Care. Feb. 2018 [Epub ahead of print]

    Distinguishing child abuse fractures from rickets. Oestreich AE. Pediatric Radiology. March 2018. 

    A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment. Ghanem MAH, Moustafa TA, Megahed HM, et al. Journal of Forensic and Legal Medicine. Feb. 2018. 

    Nonaccidental injury presenting as unilateral Retinal Detachment in two infants. Sornalingam K, Borman AD, and Ashworth J. Journal of American Association for Pediatric Ophthalmology and Strabismus. Feb. 2018. 

    A systematic autopsy survey of human infant bridging veins. Chesire EC, Malcomson RDG, Sun P, et al. International Journal of Legal Medicine. March 2018. 

    Fracture Patterns Differ Between Osteogenesis Imperfecta and Routine Pediatric Fractures. Peddada KV, Sullivan BT, Margalit A, et al. Journal of Pediatric Orthopaedics. January 2018 [epub ahead of print]. 

    Benign extracerebral fluid collection complicated by subdural hematoma and fluid collection: clinical characteristics and management. Lee HC, Chong A, Lee JY, et al. Child's Nervous System. February 2018. 

    2017

    2017

    Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma. Baerg J, Thirumoorthi A, Hazboun R, et al. Journal of Surgical Research. November 2017. 

    Retinal haemorrhage in infants with pertussis. Raoof N, Pereira S, Dai S, Neutze J, Grant CC, Kelly P. BMJ: Archives of Disease in Childhood. December 2017 [epub ahead of print]

    Pathophysiological and behavioral deficits in developing mice following rotational acceleration-deceleration traumatic brain injury. Wang G, Zhang XP, Gao Z, et al. Disease Models and Mechanisms. November 2017. 

    Development of a finite-element eye model to investigate retinal hemorrhages in shaken baby syndrome. Nadarasa J, Deck C, Meyer F, et al. Biomechanics and Modeling in Mechanobiology. December 2017. 

    Predictors of long-term neurological outcomes in non-accidental head injury. Chong CF, Misra SL, Escardo-Paton JA, Dai S. Eye. December 2017 [Epub ahead of print] 

    A Retrospective Study of Cervicla Spine MRI Findings in Children with Abusive Head Trauma. Governale LS, Brink FW, Pluta CP, et al. Pediatric Neurosurgery. December 2017. 

    Evaluations for abuse in young children with subudral hemorrhages: findings based on symptom severity and benign enlargment of the subarachnoid spaces. Hansen JB, Frazier T, Moffat M, et al. Journal of Neurosurgery: Pediatrics. November 2017. 

    Abusive Head Trauma and Mortality - An Analysis From an International Comparative Effectiveness Study of Children With Severe Traumatic Brain Injury. Miller Ferguson N, Sarnaik A, Miles D, et al. Critical Care Medicine. August 2017. 

    Inter-rater reliability of physical abuse determinations in young children with fractures. Buesser KE, Leventhal JM, Gaither JR, et al. Child Abuse & Neglect. October 2017. [Epub ahead of print]

    Throwing the baby out with the bath water - response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Saunders D, Raissaki M, Servaes S, et al. Pediatric Radiology. August 2017. 

    Lifetime Cost of Abusive Head Trauma at Ages 0-4, USA. Miller TR, Steinbeigle R, et al. Previ Sci. July 2017.

    Ocular Manifestations of Child Abuse. Warner N, McCans KM, Levin AV. The Eye in Pediatric Systemic Disease. June 2017. 

    In Vivo Demonstration of Traumatic Rupture of the Bridging Veins in Abusive Head Trauma. Zuccoli G, Khan AS, Panigrahy A, Tamber MS. Pediatric Neurology. April 2017.

    Pediatric abusive head trauma and stroke. Khan NR, Fraser BD, Nguyen V, et al. Journal of Neurosurgery: Pediatrics. June 2017. 

    Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation. Jenny CA, Bertocci G, Fukuda T, et al. Journal of Neurotrauma. April 2017. 

    The importance of optic nerve sheath hemorrhage as a postmortem finding in cases of fatal abusive head trauma: a 13-year study in a tertiary hospital. Puanglumyai S, Lekawanvijit S. Forensic Science International. April 2017. 

    Development and Validation of a Physical Model to Investigate the Biomechanics of Infant Head Injury. Jones M, Darwall D, Khalid G, et al. Forensics Science International. April 2017. 

    Photographic assessment of retinal hemorrhages in infant head injury: the Childhood Hemorrhagic Retinopathy Study. Bhardwaj G, Jacobs MB, Martin FJ, et al. Journal of America Association for Pediatric Ophthalmology and Strabismus. February 2017. 

    Derivation and Validation of a Serum Biomarker Panel to Identify Infants with Acute Intracranial Hemorrhage. Berger RP, Pak BJ, Kolesnikova MD. JAMA Pediatrics. April 2017 [Epub ahead of print].  

    Cervical spine imaging for young children with inflicted trauma: Expanding the injury pattern. Baerg J, Thirumoorthi A, Vannix R. et al. Journal of Pediatric Surgery. January 2017 [Epub ahead of print]. 

    Expert Witness Participation in Civil and Criminal Proceedings. Narang SK, Paul SR. Pediatrics. February 2017. 

    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. Offiah AC, Servaes S, Adamsbaum CS, et al. Pediatric Radiology. February 2017. 

    Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma. Kralik SF, Yasrebi M, Supakul N, et al. American Journal of Neuroradiology. February 2017. [Epub ahead of print]

    Prevention of Pediatric Abusive Head Trauma: Time to Rethink Interventions and Reframe Messages. Leventhal JM, Asnes AG, Bechtel K. JAMA Pediatrics. January 2017. 

    Association of a Postnatal Parent Education Program for Abusive Head Trauma With Subsequent Pediatric Abusive Head Trauma Hospitalizaton Rates. Dias MS, Rottmund CM, Cappos KM. JAMA Pediatrics. January 2017.

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. January 2017.

    2016

    2016

    Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 2: axial skeleton and differential diagnoses. Paddock M, Sprigg A, Offliah AC. Clinical Radiology. Dec 2016.  

    Evaluation of the Hypothesis that Choking/ALTE May Mimic Abusive Head Trauma. Hansen JB, Frazier T, Moffat M, Zinkus T, Anderst JD. Academic Pediatrics. Dec. 2016. [Epub ahead of print]

    Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review. Laterza Lopes NR, de Albuquerque Williams LC. Trauma, Violence, & Abuse. Nov 2016.

    Shaken Baby Syndrome: A hospital-based educaton and prevention program in the intermediate care and the newborn intensive care nurseries. Lopez-Bushnell K, Torrez D, Robertson JV, Torrez C, Strickler L. Journal of Neonatal Nursing. Oct 2016.

    Skin Lesions and Other Associated Findings in Children with Abusive Head Trauma. Luyet FM, Wipperfurth J, Palm A, Knox BL. Journal of Family Violence. Oct 2016. 

    Ophthalmologic Concerns in Abusive Head Trauma. Levin AL, Luyet FM, Knox BL. Journal of Family Violence. Sept 2016. 

    Subdural Hematoma Rebleeding in Relation to Abusive Head Trauma. Knox BL, Rorke-Adams LB, Luyet FM. Journal of Family Violence. Sept 2016.

    Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes. Sariaslan A, Sharp DJ, D'Onofrio BM, Larsson H, Fazel S. PLoS Med. August 2016. 

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. August 2016.  

    Acceptance of Shaken Baby Syndrome and Abusive Head Trauma as Medical Diagnoses. Narang SK, Estrada C, Greenberg S, Lindberg DM. Pediatrics. July 2016. [Epub ahead of print]

    Abusive head trauma: an epidemiological and cost analysis. Boop S, Axente M, Weatherford B, Klimo P Jr. J Neurosurg Pediatr. July 2016 [Epub ahead of print]

    Accuracy of the history of injury obtained from the caregiver in infantile head trauma. Amagasa S, Matsui H, Tsuji S, Moriya T, Kinoshita K. Am J Emerg Med. June 2016. [Epub ahead of print]

    The classic metaphyseal lesion and traumatic injury. Thackeray JD, Wannemacher J, Adler BH, Lindberg DM. Pediatr Radiol. July 2016. 

    Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Berger RP, Fromkin J, Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Pediatrics. July 2016. 

    Fatal Abusive Head Trauma Among Children Aged <5 years - United States, 1999-2014. Spies EL, Klevens J. MMWR Morb Mortal Wkly Rep. May 2016. 

    Preventing Shaken Baby Syndrome: Evaluation of a Multiple-Setting Program. Stoltz HE, Brandon DJ, Wallace HS, Tucker EA. Journal of Family Issues. May 2016 [Epub ahead of print]

    Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Ryan ME, Jaju A, Ciolino JD, Alden T. Neuroradiology. April 2016 [Epub ahead of print]

    The natural history of retinal hemorrhage in pediatric head trauma. Binenbaum G, Chen W, Huang J, Ying GS, Forbes BJ. J AAPOS. April 2016. 

    Paid family leave's effect on hospital admissions for pediatric abusive head trauma. Klevens J, Luo F, Xu L, Peterson C, Latzman NE. Inj Prev. February 2016. [Epub ahead of print]

    Hospital Variation in Cervical Spine Imaging of Young Children with Traumatic Brain Injury. Henry MK, Zonfrillo MR, French B, Song L, Feudtner C, Wood JN. Acad Pediatr. February 2016. [Epub ahead of print]

    A statewide nurse training program for a hospital based infant abusive head trauma prevention program. Nocera M, Shanahan M, Murphy RA, Sullivan KM, Barr M, Price J, Zolotor A. Nurse Educ Pract. January 2016.

    Pediatric Ophthalmologists' Experiences With Abusive Head Trauma. Sussenbach EC, Siatkowski RM, Ding K, Yanovitch TL. J Pediatr Ophthalmol Strabismus. January 2016.

    2015

    2015

    Neuroimaging differential diagnoses to abusive head trauma. Girard N, Brunel H, Dory-Lautrec P, Chabrol B. Pediatr Radiol. December 2015. [Epub ahead of print]

    Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina. Zolotor AJ, Runyan DK, Shanahan M, Durrance CP, Nocera M, Sullivan K, Klevens J, Murphy R, Barr M, Barr RG. JAMA Pediatr. December 2015.

    An evidence-based method for targeting an abusive head trauma prevention media campaign and its evaluation. Stewart TC, Gilliland J, Parry NG, Fraser DD. J Trauma Acute Care Surg. November 2015.

    Development of a screening MRI for infants at risk for abusive head trauma. Flom L, Fromkin J, Panigrahy A, Tyler-Kabara E, Berger RP. Pediatr Radiol. November 2015. [Epub ahead of print]

    Abusive head trauma: two case reports. Kanık A, İnce OT, Yeşiloğlu Ş, Eliaçık K, Bakiler AR. Turk Pediatri Ars. September 2015.

    Validation of a Prediction Tool for Abusive Head Trauma. Cowley LE, Morris CB, Maguire SA, Farewell DM, Kemp AM. Pediatrics. August 2015.

    Outcomes and factors associated with infant abusive head trauma in the US. Nuño M, Pelissier L, Varshneya K, Adamo MA, Drazin D. J Neurosurg Pediatr. July 2015. [Epub ahead of print]

    Long-term outcome in a case of shaken baby syndrome. Bartschat S1, Richter C2, Stiller D2, Banschak S3. Med Sci Law. June 2015.

    The evaluation of suspected child physical abuse. Christian CW; Committee on Child Abuse and Neglect, American Academy of Pediatrics. Pediatrics. May 2015.

FAQ

  • What is Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    What is Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    The American Academy of Pediatrics describes Shaken Baby Syndrome as: a term often used by physicians and the public to describe abusive head trauma inflicted on infants and young children. Although shaking an infant has the potential to cause neurologic injury, blunt impact or a combination of shaking and blunt impact cause injury as well.

    What happens to the brain during a shaking event?

    What happens to the brain during a shaking event?

    An infant’s brain has a higher water content and less myelination than an adult brain and is more gelatinous and is easily compressed and distorted within the skull during a shaking episode. When shaken, the brain rotates relative to a more stationary skull, creating rotational and angular forces of the head. The lag time between the movement of the skull and the brain creates stress and tearing of blood vessels. The vessel injury leads to brain bleeding, or subdural hemorrhages.

    What are subdural hemorrhages?

    What are subdural hemorrhages?

    A subdural hematoma, or hemorrhage, is usually caused by a head injury strong enough to burst blood vessels. This can cause pooled blood to push on the brain. Trauma to the head tears blood vessels that run along the surface of the brain.

    How much force is necessary to cause injuries in Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)? How many times do you have to shake an infant or young child to cause damage?

    How much force is necessary to cause injuries in Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)? How many times do you have to shake an infant or young child to cause damage?

    The injuries seen in cases of SBS/AHT are caused by violent shaking and, in some cases, impact. This is due to the rapid and repeated acceleration and deceleration of the victim’s head whipping back and forth and side to side. Shaking injuries are not caused by casual or accidental handling of children. Shaking injuries require massive, violent force. One shake is all it takes to cause traumatic brain injuries in an infant.

    What is the retina of the eye?

    What is the retina of the eye?

    The retina is a light-sensitive layer at the back of the eye that covers about 65 percent of its interior surface. Photosensitive cells calls rods and cones in the retina convert light energy into signals that are carried to the brain by the optic nerve. In the simplest terms, the retina is the lining of the inside of the eyes.

    What happens to the eyes during a shaking event?

    What happens to the eyes during a shaking event?

    The same kind of violent motion that happens in the brain during shaking also occurs in the eye. When a child is violently shaken, the eyeball and its contents move back and forth in many different directions within the eye socket. The forces produced during a shaking episode may cause the layers of the retina to slide across each other creating stretching and shearing of the retinal vessels resulting in hemorrhages.

    What are retinal hemorrhages and what is their relationship to Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    What are retinal hemorrhages and what is their relationship to Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    Bleeding in the layers of the retina are called retinal hemorrhages. Retinal hemorrhages, especially those at the ora serrata and those involving many layers of the retina are frequently seen in SBS/AHT victims and are uncommon in other types of head injury. Retina hemorrhages typically happen in both eyes (bilateral) but can also be unilateral (one eye). This type of bleeding can only be viewed by a doctor using specialized equipment.

    What other types of injuries might occur as a result of shaking?

    What other types of injuries might occur as a result of shaking?

    Other injuries that can occur as a result of shaking are cerebral edema (brain swelling), cerebral contusions (brain bruises), external head bruises, body bruises, skull fractures, rib fractures, long bone fractures, neck and spinal cord damage, or other injuries that cannot be explained through a medical condition or accidental trauma.

    Do falls cause injuries similar to Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    Do falls cause injuries similar to Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    Accidental falls, even down stairways, are not generally the cause of brain injuries in infants. Household falls from furniture or down stairs most commonly result in minor trauma. High-velocity impact injuries, falls from extreme heights, or falls onto extremely hard surfaces provide the opportunities for more severe injuries, like those seen in SBS/AHT injuries.

    Predisposing factors in Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    Predisposing factors in Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    Common factors associated with increased risk of child abuse are often individual characteristics, substance abuse, and young age of the parent or caregivers; the age, health, physical, mental, emotional, and social development of the child; history of violence within the family structure; poverty and economic conditions, social attitudes, promotion of violence, and cultural norms of the community; lack of education and resources for the family.

    What are CT scans and MRIs and how are they used to diagnose Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    What are CT scans and MRIs and how are they used to diagnose Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    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 in the brain tissue. Most skull fractures can be best shown with an X-ray.

    How can the injuries be dated and the time of injuries be determined?

    How can the injuries be dated and the time of injuries be determined?

    Clinical history, physiologic data, and imaging are the three (3) sources physicians use to establish the timing of head injuries.

    What is the outcome or prognosis of victims of Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    What is the outcome or prognosis of victims of Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT)?

    The outcomes for victims of SBS/AHT largely depend on the severity of the abuse. One third (1/3) of SBS/AHT victims who develop symptoms either do not have significant disabling conditions or the outcomes are less well-defined. Mild injuries might include learning disabilities, personality changes, or behavior problems. Other children have seizure disorders, developmental, or mental delays. Many children are left with blindness, profound reduced mental capacity, spastic diplegia (paralysis of both sides), or quadriplegia (all sides). Some children develop cerebral palsy or some continue to live in a persistent vegetative state.

    How can Shaken Baby Syndrome/Abusive Head Trauma (AHT) be prevented?

    How can Shaken Baby Syndrome/Abusive Head Trauma (AHT) be prevented?

    Child abuse, and specifically SBS/AHT, is prevented through parent/caregiver education classes about normal infant crying patterns, increased general public awareness, respite care for overwhelmed parents/caretakers, parents having a plan of action for when they become upset or exhausted while taking care of an infant/child, a parent putting the infant/child down in a safe place and walking away until they regain composure, parents/caregivers asking for help from family members or friends, and having the infant/child evaluated by a doctor if there are concerns about the baby’s physical condition.

     

Guest Commentary

    • In the Midst of Child Abuse, the Face of an Angel

      Lawrence R. Ricci, MD

      blue baby booties hang on wall

       

      Angel was then, and is even now, one of the most beautiful babies I have ever seen and I have seen many in my thirty years as a child abuse pediatrician. Yet, to look at her today, asleep against her foster mother’s shoulder, one could never guess at the devastation wrought upon her.

      I first met Angel, then only a few months old, in the pediatric intensive care unit just before Christmas. She had been admitted unresponsive the night before. Her father had told the hospital staff that he had picked her up from her crib tochange her soaked diaper and as he did so she slipped from his grasp and fell back into her crib. He said she went limp and stopped breathing. He rushed her into his car and drove wildly to the local hospital. Eventually, Angel ended up in my hospital.

      I was called in to see her after a CT scan showed subdural hematomas. Later, an MRI found evidence of parenchymal injury. An ophthalmology exam found such severe hemorrhages retinal hemorrhages that they were visible on the MRI.

      Angel’s mother was at work when the injury occurred and only found out about it after Angel was rushed to the hospital. She told me what her boyfriend had told her, that Angel had fallen from his grasp into the crib. She said she had no reason to believe otherwise.

      I finished the interview with Angel’s mother then spoke with her father. He was anxious and somewhat furtive. He told me that Angel had “peed everywhere,” on her clothes, in her bed. When he went to pick her up, she slipped from his grasp and fell onto the mattress. She immediately lost consciousness.

      I ended the interview after a few more questions about the fall, and we both went back into the ICU, he to his baby’s side, me to the computer workstation to type my note. As I typed, Angel’s mother came up to me and said that she now knew what had happened. Her boyfriend had just then confessed to her that he had shaken Angel and that he wanted to talk to me.

      I went into Angel’s hospital room. Her father was sitting on the cot with his head in his hands, Angel’s mother by his side consoling him. He didn’t look like a bad person; perpetrators rarely do.

      Before I could speak he offered, “I’m sorry Doc. I lied. I shook her.”

      I asked him why he had shaken her. “I picked her up from the crib. She was screaming and kicking and scratching at me, and I just lost it. I shook her.”

      “Did the fall happen?”

      “No, Doc. She didn’t fall. I shook her.”

      And finally “What happened after you shook her?

      “She went limp and stopped breathing. She looked dead. I know what I did was wrong. I’m sorry Doc.”

      So there it was. I thanked him for telling me the truth. I told him it was the right thing to do and left to notify the police.

      Months later, Angel’s father pled guilty to assault. He said at his sentencing that he had shaken Angel and that he was sorry. He is serving several years in prison.

      All of that was yet to pass. Here was Angel in the ICU, profoundly brain damaged, never to awake, a victim of devastating violence, and for all the world she looked like a healthy, beautiful, three-month-old girl about to experience her first Christmas. Having seen too many shaken babies, it always astounds me how normal many of these babies look, few if any bruises, no obvious fractures, nothing to suggest the violence that had been perpetrated on them. To look at her in her hospital bed, surrounded by beeping instruments and tubes, intubated, not breathing, to look at her face and body, she looked fine, not a scratch, cherubic.

      I saw her one last time several months later accompanied by her foster parents. Her functioning at a year was that of a one month old. Her existence, like that of a light switch without nuance, flipped between screaming/arching and deep sedation. She was quadriplegic, blind, and deaf. Her foster parents attend to her every day and every night, ceaselessly, religiously. I am myself not religious and have never said to anyone “God bless you.” I did to them. My eyes filling, I told them they were saints who deserved a special place in heaven.

      There is something of a “debate” within the legal community and on the fringes of the scientific community about the existence of shaken baby syndrome. One argument offered is that confessions are always coerced. Another is that shaking cannot cause these injuries. Those who would say such things should talk to Angel’s father.

      Yet, for Angel, none of this matters. Words and events orbit around her like so many errant planets: shaken baby prevention, child protective custody, termination of parental rights, grand jury, criminal prosecution, plea bargain, prison. Unknown and unknowing, immutably beautiful, she spins silently within her own dying sun.

      God bless you Angel and may flights of angels sing thee to thy rest.

      Re-posted with permission from Dr. Lawrence Ricci. 

      Read on KevinMD.com

    2016

    2016

    April: Report questioning shaken baby syndrome seriously unbalanced

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National Center on Shaken Baby Syndrome
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Farmington, Utah 84025

office: (801) 447-9360
fax: (801) 447-9364

 

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