Child's Nervous System

, Volume 33, Issue 9, pp 1423–1424 | Cite as

Response to Lyn∅e: questions about isolated trauma shaking and confessions

  • Matthieu VinchonEmail author
Author’s Reply

Thank you for your interest in our study and the interesting questions you raise. In this study, our aim was to validate and if possible sharpen the predictive value of clinical findings for the diagnostic of abusive head trauma (AHT) and to escape the “circularity trap” (basing the diagnosis on clinical findings then evaluating the diagnostic value of the same clinical finding).

We had not intent to replace the classical triad with another (and even less to christen it). The reason why we replaced the general notion of “retinal hemorrhage” (RH) by diffuse (or severe) RH (question 2) was that several studies have shown the presence of mild RH in accidental trauma [1, 2], and we found that severe RH, extending to the periphery of the retina were found only in the context of AHT. In our study, we also found that cerebral edema (or encephalopathy), although a strong predictor of AHT, was present only in a minority of cases (the most severe ones), and was thus affected by a high rate of...


  1. 1.
    Johnson DL, Braun D, Friendly D (1993) Accidental head trauma and retinal hemorrhage. Neurosurgery 33:231–234PubMedGoogle Scholar
  2. 2.
    Vinchon M, Noizet O, Defoort-Dhellemmes S, Soto-Ares G, Dhellemmes P (2002) Infantile subdural hematomas due to traffic accidents. Pediatr Neurosurg 37:245–253CrossRefPubMedGoogle Scholar
  3. 3.
    Jayawant S, Rawlinson A, Gibbon F, Price J, Schulte J, Sharples P, Sibert JR, Kemp AM (1998) Subdural haemorrhages in infants: population-based study. BMJ 317:1558–1561CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Vinchon M (2011) (2011): reply to Pr Charles Hyman: the scientific controversy over abusive head trauma in infants. Childs Nerv Syst 27:203–204CrossRefGoogle Scholar
  5. 5.
    Vinchon M, Pierrat V, Tchofo PJ, Soto-Ares G, Dhellemmes P (2005) Traumatic intracranial hemorrhage in newborns. Childs Nerv Syst 21:1042–1048CrossRefPubMedGoogle Scholar
  6. 6.
    Whitby EH, Griffiths PD, Rutter S, Smith MF, Sprigg A, Ohadike P, Davies NP, Rigby AS, Paley MN (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363(9412):846–851CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Pediatric NeurosurgeryUniversity Hospital, Hôpital Roger SalengroLille CedexFrance

Personalised recommendations