Effective prevention of abusive head trauma (AHT) requires the identification of potential perpetrators. Current evidence suggests that infant shaking, as a mechanism of AHT, produces immediate symptoms, allowing for the dating of the event based on clinical symptoms. Determining precisely when symptoms occurred may help law enforcement to identify the perpetrator. We retrieved written legal statements and medical records from birth to age at diagnosis of 100 infants consecutively diagnosed with AHT through shaking (2011–17), using forensic expertise files. Timing of abuse allowed for the identification of perpetrators in 91 cases. All abusive events occurred inside a home (parent's or nanny's), never outdoors or in a public place, and always in the presence of only one adult. Approximately one-third (n = 32) of the perpetrators were males (31 fathers) and two-thirds (n = 59) were females: 49 of them were the infant's nanny and ten were the infant's mother. Infants were not described as crying habitually. Better knowledge of the context of AHT events and risk situations, including recent implementation of a new or unusual modality of childcare, and being the only adult in a home with an infant, should facilitate prevention, including targeted training and avoidance of situations associated with risk.

中文翻译：

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通过摇晃虐待头部创伤：根据创伤事件的年代对肇事者进行检查

有效预防虐待性头部外伤 (AHT) 需要识别潜在的肇事者。目前的证据表明，婴儿颤抖作为 AHT 的一种机制，会产生即时症状，从而可以根据临床症状确定事件的年代。准确确定出现症状的时间可能有助于执法部门识别肇事者。我们使用法医专业文件检索了 100 名通过摇晃连续诊断为 AHT 的婴儿（2011-17 年），从出生到诊断年龄的书面法律声明和医疗记录。在 91 起案件中，虐待的时间允许确定肇事者。所有的虐待事件都发生在家里（父母或保姆的家里），从不在户外或公共场所，而且总是只有一个成年人在场。大约三分之一 ( n = 32) 肇事者是男性（31 个父亲），三分之二（n  = 59）是女性：其中 49 人是婴儿的保姆，十人是婴儿的母亲。婴儿没有被描述为习惯性地哭泣。更好地了解 AHT 事件和风险情况的背景，包括最近实施的新的或不寻常的儿童保育方式，以及作为家里唯一有婴儿的成年人，应该有助于预防，包括有针对性的培训和避免与风险相关的情况.