“Shaken baby syndrome” and forensic pathology

Excerpt

The paper by Byard raises important issues surrounding the diagnosis of so-called shaken baby syndrome (SBS) [1]. Legal medicine, neuropathology, neuroradiology, and other disciplines form a large center in Hamburg, Germany for the examination of accidental and non-accidental head injuries suffered during childhood. Of the various head injuries suffered, cases of SBS, which cannot be clearly proven, are often reported for assessment; in particular, those cases which do not conform to all the criteria for the so-called diagnostic triad of SBS (encephalopathy, subdural hematoma, and retinal hemorrhages). A reliable examination of these difficult cases demands a multidisciplinary approach that takes into consideration complete review of the history, including the child’s state after the incident. It is not appropriate to declare the probability of SBS based on a momentary depiction of clinical examination results, such as the existence of retinal hemorrhages. For a comprehensive assessment, all examination results relating to the child’s medical history and the child’s further development have to be considered. For example, how has the child developed so far? Is the alleged history of an accident plausible and consistent? What were the emergency doctor’s on-site observations? …