Citation

Barnes P. Univ. Mich. J. Law Reform 2016; 50(3): 679-692.

Copyright

(Copyright © 2016, University of Michigan Law School)

DOI

unavailable

PMID

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Abstract

Imaging technology started being used many years ago to help detect child abuse using x-rays used to look at the bones including the skull and make the diagnosis. Doctors would then look in the eyes and see retinal hemorrhages. Then maybe a neurosurgeon would come along and drain a subdural hematoma. In later years, we started using more advanced imaging techniques such as CT and MRI. And then somehow imaging became a gold standard, without a basic science foundation (e.g. neuropathology, biomechanics) which is part of our problem in distinguishing nonaccidental injury (NAI) from accidental injury or from medical conditions that "mimic" NAI.

Over the past few decades, there's been a building movement to relook at Shaken Baby Syndrome (SBS) and child abuse in general. The diagnosis of SBS was based on the "triad" of subdural hemorrhage, retinal hemorrhage, and brain injury.1 The triad was considered pathognomonic of SBS particularly when the caretaker history was considered inconsistent with the degree or extent of the injury. And occasionally, there were also fractures present (the tetrad). 2 However, the diagnostic criteria have evolved over time in the response to challenges to the triad doctrine....

Available at: http://repository.law.umich.edu/mjlr/vol50/iss3/6

Language: en