The legal challenges to the diagnosis of shaken baby syndrome or how to counter 12 common fake news

Background The shaken baby syndrome (SBS) is a common cause of severe traumatic lesions in infants. Although well established for almost five decades, SBS and its diagnosis are becoming more and more aggressively challenged in courts. These challenges feed on the scientific debate and controversies...

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Bibliographic Details
Published in:Child's nervous system 2022-01, Vol.38 (1), p.133-145
Main Authors: Vinchon, Matthieu, Noulé, Nathalie, Karnoub, Melodie-Anne
Format: Article
Language:English
Subjects:
Child
Child Abuse - diagnosis
Diagnosis, Differential
Disinformation
Hematoma, Subdural - etiology
Humans
Infant
Life Sciences
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Original Article
Shaken Baby Syndrome - diagnosis
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Summary:Background The shaken baby syndrome (SBS) is a common cause of severe traumatic lesions in infants. Although well established for almost five decades, SBS and its diagnosis are becoming more and more aggressively challenged in courts. These challenges feed on the scientific debate and controversies regarding the pathophysiology and the differential diagnoses, scientific uncertainty being readily exploited by specialized barristers. Material and methods In the present review, we analyze the most common challenges to the concept of SBS and its diagnosis, as well as the scientific evidence available to counter these challenges, the differential diagnoses, and how SBS can be diagnosed with confidence. Results We found that the pathophysiology of SBS is well documented, with stereotyped descriptions by perpetrators, in good correlation with experimental studies and computer models. SBS is a well-defined clinico-pathological entity with a characteristic constellation of lesions; with a rigorous evaluation protocol, its diagnosis can be made rapidly and with excellent accuracy beyond a reasonable doubt. Conclusion It is important that medical experts master an extensive knowledge regarding the pathophysiology of the lesions of SBS, in particular infantile subdural hematomas, as well as other CSF-related conditions. This emphasizes the role that pediatric neurosurgeons should play in the clinical and medicolegal management of these patients.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-021-05357-8