scholarly journals Is external hydrocephalus a possible differential diagnosis when child abuse is suspected?

2021 ◽  
Author(s):  
Joseph Scheller ◽  
Knut Wester
Keyword(s):  
Head Trauma ◽  
Head Circumference ◽  
Shaken Baby Syndrome ◽  
Abusive Head Trauma ◽  
Age Difference ◽  
Initial Symptom ◽  
External Hydrocephalus ◽  
Diagnostic Pitfall ◽  
The Us ◽  
Retinal Haemorrhages

Abstract Background Criteria for diagnosing abusive head trauma (AHT) or “shaken baby syndrome” are not well defined; consequently, these conditions might be diagnosed on failing premises. Methods The authors have collected a total of 28 infants, from the US (20) and Norway (8), suspected of having been violently shaken, and their caregivers had been suspected, investigated, prosecuted or convicted of having performed this action. Among 26 symptomatic infants, there were 18 boys (69%) and 8 girls (31%)—mean age 5.1 month, without age difference between genders. Results Twenty-one of 26 symptomatic children (81%) had a head circumference at or above the 90 percentile, and 18 had a head circumference at or above the 97 percentile. After macrocephaly, seizure was the most frequent initial symptom in 13 (50%) of the symptomatic infants. Seventeen (65%) of the symptomatic infants had bilateral retinal haemorrhages, and two had unilateral retinal haemorrhages. All infants had neuroimaging compatible with chronic subdural haematomas/hygromas as well as radiological characteristics compatible with benign external hydrocephalus (BEH). Conclusions BEH with subdural haematomas/hygromas in infants may sometimes be misdiagnosed as abusive head trauma. Based on the authors’ experience and findings of the study, the following measures are suggested to avoid this diagnostic pitfall: medical experts in infant abuse cases should be trained in recognising clinical and radiological BEH features, clinicians with neuro-paediatric experience should always be included in the expert teams and reliable information about the head circumference development from birth should always be available.

Abusive Head Trauma: The Relationship of Perpetrators to Their Victims

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 259-262 ◽  
Author(s):  
Suzanne P. Starling ◽  
James R. Holden ◽  
Carole Jenny
Keyword(s):  
Head Trauma ◽  
Significant Proportion ◽  
Shaken Baby Syndrome ◽  
Abusive Head Trauma ◽  
Male Victims ◽  
Effective Prevention ◽  
Physically Abused ◽  
Female Baby ◽  
Relationship Of ◽  
The Relationship

Objective. Abusive head trauma is the most common cause of morbidity and mortality in physically abused infants. Effective prevention requires the identification of potential perpetrators. No study has specifically addressed the relationship of the perpetrators of abusive head trauma ("shaken baby syndrome") to their victims. The objectives of this study were to identify the abusers and their relationship to victims in these cases. Methods. We reviewed the medical charts of 151 infants who suffered abusive head trauma to determine the perpetrator of the abuse. Caretakers were classified by level of certainty: confession to the crime, legal actions taken, or strong suspicion by the staff. The relationship of abusers to victims was analyzed. Results. Male victims accounted for 60.3% of the cases. Twenty-three percent of the children died, although death rates for boys and girls did not vary significantly. Male perpetrators outnumbered females 2.2:1, with fathers, step-fathers, and mothers' boyfriends committing over 60% of the crimes. Fathers accounted for 37% of the abusers, followed by boyfriends at 20.5%. Female baby-sitters, at 17.3%, were a large, previously unrecognized group of perpetrators. Mothers were responsible for only 12.6% of our cases. All but one of the confessed abusers were with the child at the time of onset of symptoms. Conclusions. Our data suggest male caretakers are at greater risk to abuse infants. Baby-sitters are a concerning risk group, because they represent a significant proportion of abusers, and they more easily escape prosecution. In addition, no prevention efforts have been directed at baby-sitters. These statistics could help change the focus of efforts to prevent abusive head trauma.

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

2013 ◽  
Author(s):  
Sandeep K. Narang ◽  
John David Melville ◽  
Christopher S. Greeley ◽  
James D. Anderst ◽  
Shannon L. Carpenter ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Head Trauma ◽  
Shaken Baby Syndrome ◽  
Abusive Head Trauma

scholarly journals Abusive head trauma in court: a multi-center study on criminal proceedings in Germany

2020 ◽  
Vol 135 (1) ◽  
pp. 235-244
Author(s):  
Katharina Feld ◽  
Dustin Feld ◽  
Bernd Karger ◽  
Janine Helmus ◽  
Nneka Schwimmer-Okike ◽  
...  
Keyword(s):  
Head Trauma ◽  
Family Environment ◽  
Shaken Baby Syndrome ◽  
Abusive Head Trauma ◽  
Infants And Toddlers ◽  
Criminal Proceedings ◽  
Multi Center Study ◽  
Living Children ◽  
Close Family ◽  
Center Study

AbstractThe shaken baby syndrome (SBS) is a common variant of abusive head trauma (AHT) in infants and toddlers. Data on the legal outcome of such cases are still sparse. By means of a retrospective multi-center analysis, 72 cases of living children diagnosed with SBS/AHT from three German university institutes of legal medicine were identified. Forty-six of these cases with 68 accused individuals were available and could be evaluated with regard to basic data on the course of the criminal proceedings as well as the profile of the defendants (sub-divided into suspects, convicts, and confessed perpetrators). Criminal proceedings predominantly commenced with a complaint by the treating hospital (62%) and were found to be closed (without judgment) in 50% of the cases, mostly due to a “lack of sufficient suspicion.” Of the 23 cases with judgment, the court decided on acquittal in 4 cases (17%). Imprisonment was the most frequent sentence (16 out of 19 cases with conviction, 84%), whereby the sentence has been suspended on probation in 63% of the cases. Suspects and perpetrators were mostly male and derived from the close family environment of the injured children. All confessed perpetrators stated an “excessive demand” as the reason for the violent shaking of the child. The results of the present study are in line with data from other studies with other legal systems. As many criminal proceedings were closed and the 4 acquittals occurred because the perpetration could not be ascribed to a specific perpetrator, improving the forensic methods for such an unequivocal assignment would be desirable.

Overturned abusive head trauma and shaken baby syndrome convictions in the United States: Prevalence, legal basis, and medical evidence

2021 ◽  
Vol 122 ◽  
pp. 105380
Author(s):  
S.K. Narang ◽  
K.K. Sachdev ◽  
K. Bertocci ◽  
M.J. Pierre-Wright ◽  
K. Kaczor ◽  
...  
Keyword(s):  
United States ◽  
Head Trauma ◽  
Shaken Baby Syndrome ◽  
Abusive Head Trauma ◽  
The United States ◽  
Legal Basis ◽  
Medical Evidence
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