ArticleThe western journal of emergency medicine2011
Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome.
Article in The western journal of emergency medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- A meta-analysis of prognostic biomarkers in neonatal retinal hemorrhage.International ophthalmology · 2022Pooled it
- Pathophysiological hypotheses of the triad in abusive infant shaking: A systematic review and analysis of corroborated cases.Forensic science international. Synergy · 2025Article
- Finite element analysis of asymmetrical retinal hemorrhages in shaken baby syndrome.Medical hypothesis, discovery & innovation ophthalmology journal · 2025Article
- New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Exploring the Vitreoretinal Interface: A Key Instigator of Unique Retinal Hemorrhage Patterns in Pediatric Head Trauma.Korean journal of ophthalmology : KJO · 2022Article
- Chronic subdural hemorrhage predisposes to development of cerebral venous thrombosis and associated retinal hemorrhages and subdural rebleeds in infants.The neuroradiology journal · 2022Article
- Rare case of Terson's syndrome and viral retinitis due to dengue haemorrhagic fever in an infant.BMJ case reports · 2021Article
- Medical diagnoses among infants at entry in out-of-home care: A Swedish population-register study.Health science reports · 2019Article
- Consensus statement on abusive head trauma in infants and young children.Pediatric radiology · 2018Review
- Infant abuse diagnosis associated with abusive head trauma criteria: incidence increase due to overdiagnosis?European journal of public health · 2018Article
- Shaken baby syndrome is real.Pediatric radiology · 2018Article
- Child abuse: we have problems.Pediatric radiology · 2016Article
- The significance of macrocephaly or enlarging head circumference in infants with the triad: further evidence of mimics of shaken baby syndrome.The American journal of forensic medicine and pathology · 2015Article
- "Shaken baby syndrome" and forensic pathology.Forensic science, medicine, and pathology · 2014Article
- "Shaken baby syndrome" and forensic pathology: an uneasy interface.Forensic science, medicine, and pathology · 2014Article
- "Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage, and Shaken Baby Syndrome".The western journal of emergency medicine · 2012Article
- Letters to the editor.The western journal of emergency medicine · 2012Article
- Ocular findings in the evaluation of abusive head trauma in children.Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological SocietyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Child abuse experts use diagnostic findings of subdural hematoma and retinal hemorrhages as near-pathognomonic findings to diagnose shaken baby syndrome. This article reviews the origin of this link and casts serious doubt on the specificity of the pathophysiologic connection. The forces required to cause brain injury were derived from an experiment of high velocity impacts on monkeys, that generated forces far above those which might occur with a shaking mechanism. These forces, if present, would invariably cause neck trauma, which is conspicuously absent in most babies allegedly injured by shaking. Subdural hematoma may also be the result of common birth trauma, complicated by prenatal vitamin D deficiency, which also contributes to the appearance of long bone fractures commonly associated with child abuse. Retinal hemorrhage is a non-specific finding that occurs with many causes of increased intracranial pressure, including infection and hypoxic brain injury. The evidence challenging these connections should prompt emergency physicians and others who care for children to consider a broad differential diagnosis before settling on occult shaking as the de-facto cause. While childhood non-accidental trauma is certainly a serious problem, the wide exposure of this information may have the potential to exonerate some innocent care-givers who have been convicted, or may be accused, of child abuse.
Identifiers
21691518PMC3099599W1668742223What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.