Background

Abusive Head Trauma (AHT) due to shaking is one of the most serious types of child abuse. An inflicted blunt force trauma or repetitive accelerationdeceleration trauma in infants can cause brain injury.

Objective: Head acceleration was measured during manual shaking and a free fall from a height of 1 m (3 ft). An experiment employing Inertial Measurement Units (IMUs) was carried out to determine the values of acceleration to which individual body parts were exposed.

Participants and setting

In the article we report the case of a two-month-old female infant with suspected Shaken Baby Syndrome (SBS). Subdural bilateral haemorrhages were detected. An ophthalmological examination confirmed diffuse bilateral retinal damage with retinal ecchymoses. The infant was disqualified from neurosurgery and instead received treatment in the intensive care unit, which included antioedematous therapy and respiratory support. The girl died after one month in the intensive care unit (ICU).

Results

A forensic autopsy revealed no congenital abnormalities or signs of preexisting diseases. Ischaemic damage to the brain tissue was discovered. Based on autopsy findings, it was established that the death of the child most likely resulted from intracranial inertial injury. Acceleration values can reach up to 142 m/s2 in the forehead region during AHT. With a free fall from a height of 1 m to soft ground, the value was 165 m/s2. Testing has shown humans can generate only about 10–15 Gs of acceleration of the brain with the most forceful shaking. In our experiment the maximum shaking force was 14.5 G. In a free fall the g-force value was 16.8 G. The recorded impact duration was 20 ms and 26 ms, respectively.

Conclusion

The fall dynamics are influenced by fall height, initial velocity or force, and body mass. The speed on contact with the ground depends on the height of the fall and the initial velocity. Based on the results of the experiment, the authors conclude that it cannot be categorically stated that pure shaking cannot cause fatal head injuries in an infant. In this case, the statement of SBS is not unequivocal.

中文翻译：

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婴儿摇晃时会受伤吗？案例研究

背景

摇晃引起的虐待性头部创伤（AHT）是最严重的虐待儿童类型之一。婴儿遭受钝器外伤或反复加速减速外伤可导致脑部受伤。

目的：在手动摇动和从1 m（3 ft）高处自由落体期间测量头部加速度。进行了使用惯性测量单元（IMU）的实验，以确定各个身体部位所承受的加速度值。

参加者和设置

在这篇文章中，我们报告了一个2个月大的婴儿，其中疑似婴儿摇篮综合症（SBS）。发现硬膜下双侧出血。眼科检查证实双侧视网膜弥漫性损伤伴视网膜瘀斑。该婴儿被取消了神经外科手术的资格，而是在重症监护室接受了治疗，其中包括抗水肿治疗和呼吸支持。该女孩在重症监护室（ICU）一个月后死亡。

结果

法医尸检没有发现先天性异常或先前存在疾病的迹象。发现对脑组织的缺血性损伤。根据尸检结果，可以确定儿童的死亡很可能是由颅内惯性损伤造成的。在AHT期间，前额区域的加速度值可以达到142 m / s2。从1 m的高度自由下落到软土地基，其值为165 m / s2。测试表明，在最剧烈的摇动下，人只能产生大约10-15 Gs的大脑加速。在我们的实验中，最大震动力为14.5G。自由落体的g力值为16.8G。记录的冲击持续时间分别为20 ms和26 ms。

结论

跌落动力学受跌落高度，初始速度或力以及体重的影响。与地面接触的速度取决于跌落的高度和初始速度。根据实验结果，作者得出结论，不能断然指出纯摇不会对婴儿造成致命的头部伤害。在这种情况下，SBS的声明并非明确。