BMJ  2004;328:720-721 (27 March), doi:10.1136/bmj.328.7442.720

Editorial

Shaken baby syndrome

Pathological diagnosis rests on the combined triad, not on individual injuries

The first 150 words of the full text of this article appear below.

Shaken baby syndrome is a form of physical non-accidental injury to infants, characterised by acute encephalopathy with subdural and retinal haemorrhages, occurring in a context of inappropriate or inconsistent history and commonly accompanied by other apparently inflicted injuries.^{1 2} Injuries to the neck and spinal cord may also be present. Controversy surrounds the precise causation of the brain injury, the retinal and subdural haemorrhages, as well as the degree of force required and whether impact in addition to whiplash forces is needed.^{1 3 4} Although most discussion has concerned fatal injuries of this nature, not all are lethal, but they may be associated with subsequent neurological disability of varying severity.

Expert medical evidence about inflicted injury must have scientific validity, but applying the evidence based criteria appropriate to clinical practice entails some difficulties.⁵ In clinical practice medical management of defined clinical problems can be compared and best practice distinguished by clinical outcomes. Conversely, . . . [Full text of this article]

Great Ormond Street Hospital for Children, London WC1N 3JH

Great Ormond Street Hospital for Children, London WC1N 3JH

Children's Hospital San Diego, San Diego, CA 92123, USA

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This article has been cited by other articles:

• Elner, V. M. (2008). Ocular Manifestations of Child Abuse. Arch Ophthalmol 126: 1141-1142 [Full text]  
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Rapid Responses:

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Pathological diagnosis based on the triad, but where is the scientifc evidence to back it up?

Heather J Lohr
bmj.com, 29 Mar 2004 [Full text]

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