Journal of American Physicians and Surgeons Volume 9 Number 3 Fall 2004
It was not shown quantitatively that human beings could generate the required rotational acceleration by manual shaking. Nonetheless, this critical omission was not addressed until 19 years later. At that time it was shown quantitatively that impact was required to generate adequate force. Guthkelch, Caffey, and others either were not aware of, or disregarded, this critical missing piece of information. In the intervening years, and even up to the present, numerous references are made to infants sustaining inflicted brain injury by manual shaking.Yet no laboratory proof of this possibility has ever been put forth. In fact, the available experimental evidence, beginning as far back as 1943, addressed directly in 1987 and reproduced in 2003, seems to indicate the contrary.
Clinical observation and scientific experimentation and verification should complement one another. More than 30 years after the original hypothesis of shaken baby syndrome, this does
not appear to have happened.
With regard to treatment of cranio-cerebral trauma, the differentiation between accidental and inflicted injury is of limited practical importance: injuries are injuries. For social purposes,
however, the distinction is critical.
While the desire to protect children is laudable, it must be balanced against the effects of seriously harming those who are accused of child abuse solely on the basis of what is, at best,
unsettled science.Journal of American Physicians and Surgeons Volume 9 Number 3 Fall 2004 77
Ronald Uscinski, M.D., F.A.C.S. , is a neurosurgeon practicing in the Washington, D.C., area. He has consulted and testified as an expert witness for the defense in cases involving alleged child abuse, both pro bono and for time compensation. He has never consulted or testified for the prosecution, because no prosecuting entity has ever contacted him.REFERENCES
Caffey J. The parent-infant traumatic stress syndrome. 1972;114:217-228.
Caffey J. On the theory and practice of shaking infants. 1972; 24:161-169.
Caffey J. The whiplash shaken infant syndrome: Manual shaking by the extremities with whiplash-induced intracranial and intraocular pleadings, link with residual permanent brain damage and mental retardation. 1974;54;396-403.
Duhaime A, Gennarelli T, Thibault L, et al. The shaken baby syndrome.a clinical, pathological, and biomechanical study. 1987;66:409-415.
Prange M, Coats B, Duhaime A, Margulies S. Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants. 2003;99:143-150.
Ommaya AK. Whiplash injury and brain damage. 1968;204:75-79.
Holbourn AH. Mechanics of head injuries. 1943;4(Oct 9):438-441.
Holbourn AH. The mechanics of brain injuries. 1945;622:147-149.
Ommaya AK, Hirsch AE, Harris E, et al. Scaling of experimental data on cerebral concussion in subhuman primates to concussive thresholds in man. In: Proceedings of the 11th Stapp car crash
conference of automotive engineers,NewYork; 1967.Ommaya AK, Yarnell P.Guthkelch AN. Infantile subdural haematoma and its relationship to whiplash injuries. 1971;2(759):430-431.
The Shaken Baby Syndrome