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Abusive head injuries in infants: from founders to denialism and beyond

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Abusive head injuries is a major cause of severe morbidity and the main cause of mortality by head trauma in infants.

Material and methods

Based on published data and their own clinical and medicolegal practice, the authors review briefly the historical roots and emergence of the concept of abusive head injuries (AHI), until the present scientific understanding of shaken baby syndrome (SBS) and Silverman syndrome. They then discuss the present epidemic of denialism and how this challenge to science should be seen as a stimulus to increase research and improve the accuracy of diagnosis and medical practice.


The denial of SBS is especially damaging because it undermines the possibilities of prevention and reparation for victims. The authors expand on AHI being part of a wider context of domestic violence and the prevention of child abuse being part of a broad and long-term endeavor to defend civilization values.


Prevention of AHI is a major challenge for the future. In the fields of science and prevention of child abuse, the input of pediatric neurosurgeons should not be underestimated.

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  1. Vinchon M (2006) Honoré Daumier and child abuse. Childs Nerv Syst 22:635.

    Article  Google Scholar 

  2. Roche AJ, Fortin G, Labbé J, Brown J, Chadwick D (2005) The work of Ambroise Tardieu: the first definitive description of child abuse. Child Abuse Negl 29(4):325–334. (Epub 2005 Apr 26 PMID: 15917075)

    Article  Google Scholar 

  3. Kempe CH, Silverman FN, Steele BF, Droegmueller W, Silver HK (1962) The battered-child syndrome. JAMA 7(181):17–24. (PMID: 14455086)

    Article  Google Scholar 

  4. Caffey J (1972) On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation. Am J Dis Child 124(2):161–169. (PMID: 4559532)

    Article  CAS  Google Scholar 

  5. Duhaime AC, Gennarelli TA, Thibault LE, Bruce DA, Margulies SS, Wiser R (1987) The shaken baby syndrome. A clinical, pathological, and biomechanical study. J Neurosurg 66(3):409–4. (PMID: 3819836)

    Article  CAS  Google Scholar 

  6. Vinchon M, de Foort-Dhellemmes S, Desurmont M, Delestret I (2010) Confessed abuse versus witnessed accidents in infants: comparison of clinical, radiological, and ophthalmological data in corroborated cases. Childs Nerv Syst 26(5):637–645. (Epub 2009 Nov 28 PMID: 19946688)

    Article  Google Scholar 

  7. Adamsbaum C, Rambaud C (2012) Abusive head trauma: don’t overlook bridging vein thrombosis. Pediatr Radiol 42(11):1298–1300. (Epub 2012 Aug 12 PMID: 22885602)

    Article  Google Scholar 

  8. Rambaud C (2015) Bridging veins and autopsy findings in abusive head trauma. Pediatr Radiol 45(8):1126–1131. (Epub 2015 Feb 20 PMID: 25698365)

    Article  Google Scholar 

  9. Adamsbaum C, Grabar S, Mejean N, Rey-Salmon C (2010) Abusive head trauma: judicial admissions highlight violent and repetitive shaking. Pediatrics 126(3):546–555. (Epub 2010 Aug 9 PMID: 20696720)

    Article  Google Scholar 

  10. Finnie JW, Blumbergs PC, Manavis J, Turner RJ, Helps S, Vink R, Byard RW, Chidlow G, Sandoz B, Dutschke J, Anderson RW (2012) Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome). J Clin Neurosci 19(8):1159–1164. (Epub 2012 Jun 15 PMID: 22705132)

    Article  CAS  Google Scholar 

  11. Roth S, Raul JS, Ludes B, Willinger R (2007) Finite element analysis of impact and shaking inflicted to a child. Int J Legal Med 121(3):223–228. (Epub 2006 Nov 8 PMID: 17091312)

    Article  Google Scholar 

  12. Boos SC, Wang M, Karst WA et al (2022) Traumatic head injury and the diagnosis of abuse: a cluster analysis. Pediatrics 149(1):e2021051742

    Article  Google Scholar 

  13. Fox news: mother whose child was abused… last consulted on July 20th, 2022

  14. Barr RG, Barr M, Rajabali F, Humphreys C, Pike I, Brant R, Hlady J, Colbourne M, Fujiwara T, Singhal A (2018) Eight-year outcome of implementation of abusive head trauma prevention. Child Abuse Negl 84:106–114. (Epub 2018 Aug 1 PMID: 30077049)

    Article  Google Scholar 

  15. Fujiwara T (2015) Effectiveness of public health practices against shaken baby syndrome/abusive head trauma in Japan. Public Health 129(5):475–482. (Epub 2015 Mar 3 PMID: 25744111)

    Article  CAS  Google Scholar 

  16. Vinchon M, Noulé N, Karnoub MA (2022) The legal challenges to the diagnosis of shaken baby syndrome or how to counter 12 common fake news. Childs Nerv Syst 38(1):133–145. (Epub 2021 Sep 25 PMID: 34564748)

    Article  Google Scholar 

  17. Lynøe N, Elinder G, Hallberg B, Rosén M, Sundgren P, Eriksson A (2017) Insufficient evidence for ‘shaken baby syndrome’ - a systematic review. Acta Paediatr 106:1021–1027. (Epub 2017 Mar 1 PMID: 28130787)

    Article  Google Scholar 

  18. Dias MS, Smith K, DeGuehery K, Mazur P, Li V, Shaffer ML (2005) Preventing abusive head trauma among infants and young children: a hospital-based, parent education program. Pediatrics 115(4):e470–e477

    Article  Google Scholar 

  19. Zolotor AJ, Runyan DK, Shanahan M, Durrance CP, Nocera M, Sullivan K et al (2015) Effectiveness of a statewide abusive head trauma prevention program in North Carolina. JAMA Pediatr 169(12):1126–1131

    Article  Google Scholar 

  20. Peterson C, Xu L, Florence C, Parks SE, Miller TR, Barr RG et al (2014) The medical cost of abusive head trauma in the United States. Pediatrics 134(1):91–99

    Article  Google Scholar 

  21. Miller TR, Steinbeigle R, Lawrence BA, Peterson C, Florence C, Barr M et al (2018) Lifetime cost of abusive head trauma at Ages 0–4, USA. Prev Sci 19(6):695–704

    Article  Google Scholar 

  22. Tursz A, Cook JM (2014) Epidemiological data on shaken baby syndrome in France using judicial sources. Pediatr Radiol 44(Suppl 4):S641–S646

    Article  Google Scholar 

  23. Vinchon M (2017) Shaken baby syndrome: what certainty do we have? Childs Nerv Syst 33(10):1727–1733. (Epub 2017 Sep 6 PMID: 29149395)

    Article  Google Scholar 

  24. Theodore AD, Chang JJ, Runyan DK, Hunter WM, Bangdiwala SI, Agans R (2005) Epidemiologic features of the physical and sexual maltreatment of children in the Carolinas. Pediatrics 115(3):e331–e337

    Article  Google Scholar 

  25. Glasser M, Kolvin I, Campbell D, Glasser A, Leitch I, Farrelly S (2001) Cycle of child sexual abuse: links between being a victim and becoming a perpetrator. Br J Psychiatry 179:482–494; discussion 495-7. (PMID: 11731348)

  26. Lang K, Liel C, Lux U, Kindler H, Vierhaus M, Eickhorst A (2022) Child abuse potential in young German parents: predictors, associations with self-reported maltreatment and intervention use. Child Psychiatry Hum Dev 53(3):569–581. (Epub 2021 Mar 17. PMID: 33730359; PMCID: PMC9107397)

    Article  Google Scholar 

  27. National interministerial observatory for road security [Observatoire national interministériel de la sécurité routière], 2022, last consulted on August 9th, 2022

  28. Clément ME, Chamberland C, Bouchard C (2016) Prevalence, co-occurrence and decennial trends of family violence toward children in the general population. Can J Public Health 106(7 Suppl 2):eS31–eS37. (PMID: 26978698; PMCID: PMC6972253)

    Article  Google Scholar 

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Prs Matthieu Vinchon and Federico Di Rocco both made contribution in the collection of clinical data, discussions, and redaction of this manuscript.

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Correspondence to Matthieu Vinchon.

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Vinchon, M., Di Rocco, F. Abusive head injuries in infants: from founders to denialism and beyond. Childs Nerv Syst 38, 2275–2280 (2022).

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