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Article
The Significance of Macrocephaly or Enlarging Head Circumference in Infants with the Triad: Further Evidence of Mimics of Shaken Baby Syndrome
American Journal of Forensic Medicine & Pathology
  • David Miller
  • Patrick Barnes
  • Marvin E. Miller, Wright State University
Document Type
Article
Publication Date
6-1-2015
Abstract

Infants with the triad (neurologic dysfunction, subdural hematoma [SDH], and retinal hemorrhage) are often diagnosed as victims of shaken baby syndrome. Medical conditions/predisposing factors to developing the triad are often dismissed: short falls, birth-related SDH that enlarges, macrocephaly, sinus/cortical vein thrombosis, and others. Six infants with the triad are described in which child abuse was diagnosed, but parents denied wrongdoing. All 6 had either macrocephaly or enlarging head circumference, which suggested medical explanations. Three infants incurred short falls, 1 had a difficult delivery in which there was likely a rebleed of a birth-related SDH, 1 had a spontaneous SDH associated with increased extra-axial fluid spaces, and 1 had a sinus thrombosis. Following legal proceedings, all 6 infants were returned to their parents, and there has been no child maltreatment in follow-up, suggesting child abuse never happened. The results indicate that alternative medical explanations for causing the triad should be considered and that macrocephaly or an enlarging head circumference raises the possibility of a medical explanation.

Comments

Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

DOI
10.1097/PAF.0000000000000152
Citation Information
David Miller, Patrick Barnes and Marvin E. Miller. "The Significance of Macrocephaly or Enlarging Head Circumference in Infants with the Triad: Further Evidence of Mimics of Shaken Baby Syndrome" American Journal of Forensic Medicine & Pathology Vol. 36 Iss. 2 (2015) p. 111 - 120 ISSN: 01957910
Available at: http://works.bepress.com/marvin_miller/96/