Like so much else in the past year, the first two cases I’ve come across since refocusing on the shaken baby debate involve defendants of color. While any family can be the target of misguided abuse accusations, the chances go up for non-white parents and caregivers. The good news is that these cases are in the news because the courts have reconsidered.
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Dr. Norman Guthkelch, Still on the Medical Frontier, a profile of the pediatric neurosurgeon who first proposed that shaking a baby can cause brain damage
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The American Journal of Froensic Medicine and Pathology
© 2002 Lippincott Williams & wilkins, Inc.
Volume 23(1), March 2002, p. 105Symptoms Following Head Injury
(Letters to the Editor)Huntington, Robert W. III M.D.
Madison, Wisconsin, U.S.A.To the Editor:
A recent proposed position paper regarding pediatric nonaccidental abuse head injury would allege that we may depend on symptoms to appear immediately upon injury (1). I have a concern about that claim, which I will explain with the
CASE REPORT
A 13-month-old Hihspanic girl was brought to the University of Wisconsin Hospital on the morning of September 18, 1999. The complain was of vomiting that had lasted for 24 hours. She was described as irritable, sleepy, and vomiting. In our emergency room she was noted to have extensive bruises on the cheeks, chest, back, and arms; the mother attributed these to bites by a 3-year-oldhousemate. She was admitted and given intravenous fluids. She was sedated with pantothal followed by head computed tomography, which was negative. She was then admitted to the pediatric ward. The resident who saw her described her in the chart and in discussion as being fussy and clingy, but interactive and responsive. Because of the numerous bruises, the police were notified and took pictures.
At about 2:00 the following morning, a nurse coming in to care for the child noted that she had decreased respirations. It was then shown that she was unresponsive and had a ribht dilated unreactive pupil with a sluggish left pupil. She was taken emergently to the pediatric intesive care unit, where she was intubated and given mannitol. A subsequent computed tomography scan showed very poor differentiation of the gray/white matter interface. A Codman catheter was placed and then replaced with a ventriculostomy tube after an intracranial pressure of 21 mm Hg was noted.
On the evening of the day after admission, a cerebral blood flow study showed no cerebral blood flow. She was pronounced brain dead. In the interim, her mother had fled town and has not been found since.
An autopsy was done on September 20, 1999. This showed hemorrhage in t he left optic nerve sheath and left retinal hemorrhages as well as marked cerebral edema and thin widespread subdural hemorrhage. Diffuse axon injury was demonstrated with amyloid precursor protein antibody.
My point is that the child did have some symptoms, but clearly the severe intracranial injury symptoms, which were confirmed on repeat computed tomography and autopsy, were delayed for several hours, during which time she was under our view and review in the hospital. Others have noted similar problems (2).Robert W. Huntington III, M.D.
REFERENCES
• Case ME, Graham MA, Handy TC, Jentzen JM, Monteleone JA. Position paper on fatal abusive head injury in infants and young children. Am J Foresnci Med Pathol 2001; 23: 112-22.
• Gilliland MFG. Ingterval duration between injury and severe symptoms in non-accidental head trauma in infants and young children. J Forensic Sci 1998; 43: 723-5. -
On Shaken Baby · Shaken: A Diagnosis on Trial
On Shaken Baby 
Thank you so very much keeping this on the legal forefront. SBS is still not understood by the prosecutors, juries and judges. They indeed now changed the name to “Blunt force trauma” to encompass what law enforcement/old school physicians used to determine and “name” SBS, to include all the same symptoms that include accidents on a much larger scale. All the same problems exist with prosecutors ( and all their cronies)wanting to win, regardless of truth. Sometimes for some of those prosecutor’s (Macomb Co, Mi) and cronies other truths are uncovered. So much corruption, it will probably several more years to clean house.
Thank you Sue for all your support to so many. You have certainly been a beacon of light for the innocent.
I pray for the day that Michelle Heale, my niece is free.
I think of Michelle often. Thank you for your support. Best wishes to you all.
Thanks for your efforts in helping others who are wrongfully convicted and bringing more awareness on this.
Great to hear from you, Audrey. Thank you, and best wishes.
SBS is BS! Free Marsha Mills!
Thank you, Tom, for checking in. Yes, free Marsha Mills.