Dr. Lorandos Explains Shaken Baby

Dr. Lorandos explains cases involving claims of shaken baby syndrome

At http://www.falsely-accused.net/ we explain that Shaken Baby Syndrome (or SBS) is a term used to describe a constellation of injuries and the mechanism of abuse that causes these injuries.

The major signs of Shaken Baby Syndrome are subdural or subarachnoid hematomas (which are bleeding in the membranes that cover the brain), retinal hemorrhages (which are bleeding in the back of the inner surface of the eyes) with little or no external injury. In some cases there are broken ribs and fractures of the skull. The broken ribs are said to be caused by the manner in which the child is held around the rib cage during the shaking. When a fractured skull is found, it is usually seen to be caused by the head striking an object during shaking. At http://www.falsely-accused.net/ we explain that brain injury in these cases is usually caused by an individual who shakes an infant, usually under the age of two years, severely back and forth. The infants who are less than two do not have the developed neck muscles of older infants and so the head will whip and lash back and forth. Because these young infants brains do not yet fill the entire cavity of the skull, the brain becomes bruised as it literally bounces back and forth and rotates inside the skull as the child is shaken. The rapid acceleration, deceleration, and rotation of the brain also tears the bridging veins that cover its surface, which accounts for hematomas, or bleeding in the brain. The combination of surface bruising and hematomas ultimately lead to cerebral edema, or swelling of the brain. Not all infants die from shaken baby syndrome, but if the swelling of their brain cannot be controlled, the brain issue deteriorates when it runs out of space to swell within the skull. It is usually the cerebral edema, or brain swelling, that leads to death. If the child does not die, brain damage and mental retardation are common as a result of the edema.

At http://www.falsely-accused.net/ we explain that the original medical research article on SBS was written by Dr. John Caffey and it was entitled “The Whiplash Shaken Infant Syndrome: Manual Shaking by the Extremities With Whiplash-Induced Intracranial and Intraocular Bleeding, Linked With Residual Permanent Brain Damage and Mental Retardation.” There are rarely witnesses to abusive shaking. Therefore the case is usually a matter of attempting to recreate what occurred by using mechanical descriptions and analysis of the injuries. As you can imagine, these cases turn into a battle of the experts. The opinions of these professionals can be contradictory, because no one has sufficient scientific data in this area. It is not possible or ethical to create a controlled study that measures the effects of shaking on a real infants brain. Unfortunately, opinions are sometimes based on personal bias when there is little or no scientific information available. This is the case with many child advocacy experts.

At http://www.falsely-accused.net/ we remind clients that child advocacy experts claim that SBS injuries can never be caused by a fall. This is based on the idea that a short fall cannot create the necessary acceleration/deceleration forces that bruise and tear the brain tissue. But this is not always the case. Studies on artificial brains subjected to falls have shown that acceleration/deceleration forces are forty times greater when the head is suddenly stopped by an object than when the head is shaken in midair. Governmental statistical reviews of children who have suffered short distance falls show skull fractures, subdural hematomas, and subarachnoid hematomas. In addition, autopsies of automobile accident victims have described some of these same injuries. This empirical research demonstrates that it is possible for the brain to be damaged by an accidental fall or sudden accidental impact. This is why, when a parent claims that an accident occurred, the defense attorney must place into evidence research data showing that the injuries that the child sustained could have been sustained by an accident. One of the serious problems with SBS is that researchers have not actually seen a child being shaken and then done an autopsy to show or measure the injuries. Without scientific studies to guide the cross-examination of child advocacy experts, SBS is open to exaggerated claims about how violent the shaking must be in order to cause the injuries in any given case. Descriptions from the child advocacy experts of a child having to fall from a third story window or having to be slammed against the wall while being swung by the feet to sustain the alleged injuries have enormous emotional impact on a jury.