{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:55:08Z","timestamp":1792029308849,"version":"4.4.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>Confessions are uncommon in abusive head trauma (AHT) cases, and there is debate over whether shaking alone can cause the injuries characteristic of AHT. The objective of this article is to correlate legal statements by perpetrators with medical documentation to offer insights into the mechanism of injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>In this retrospective observational study we examined forensic evidence from 112 cases referred for AHT over a 7-year period. We compared 29 cases in which a perpetrator confessed to violence toward the child with 83 cases in which there was no confession. Inclusion criteria were subdural hematoma (SDH) on computed tomography and perpetrator admission of a causal relationship between the violence inflicted and the child's symptoms. Groups were compared by using Student's t test for age and Fisher's exact test for gender, death, fractures, retinal hemorrhages, ecchymoses, symptoms, and SDH patterns. All medical records from birth to diagnosis, imaging studies, and written investigation reports were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>All confessions came from forensic investigations. There was no statistically significant difference between the 2 groups for any of the variables studied. Shaking was described as extremely violent (100%) and was repeated (55%) from 2 to 30 times (mean: 10) because it stopped the infant's crying (62.5%). Impact was uncommon (24%). No correlation was found between repeated shaking and SDH densities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>This unique forensic case series confirms the violence of shaking. The high frequency of habitual AHT is a strong argument for reporting suspected cases to judicial authorities and helps to explain the difficulty in dating the injuries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2009-3647","type":"journal-article","created":{"date-parts":[[2010,8,10]],"date-time":"2010-08-10T02:04:35Z","timestamp":1281405875000},"page":"546-555","source":"Crossref","is-referenced-by-count":302,"title":["Abusive Head Trauma: Judicial Admissions Highlight Violent and Repetitive Shaking"],"prefix":"10.1542","volume":"126","author":[{"given":"Catherine","family":"Adamsbaum","sequence":"first","affiliation":[{"name":"Paris Descartes University, Paris, France; and"},{"name":"Pediatric Radiology Department, St Vincent de Paul Hospital,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Grabar","sequence":"additional","affiliation":[{"name":"Paris Descartes University, Paris, France; and"},{"name":"Unit of Epidemiology and Biostatistics, Cochin Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Mejean","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department, St Vincent de Paul Hospital,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Rey-Salmon","sequence":"additional","affiliation":[{"name":"Medico Judicial Unit, H\u00f4tel-Dieu Hospital, Assistance Publique-H\u00f4pitaux de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,9,1]]},"reference":[{"issue":"1","key":"2021121009435917700_B1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1520\/JFS13905J","article-title":"Shaken babies: some have no impact injuries","volume":"41","author":"Gilliland","year":"1996","journal-title":"J Forensic Sci"},{"issue":"3","key":"2021121009435917700_B2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3171\/jns.1987.66.3.0409","article-title":"The shaken baby syndrome: a clinical, pathological, and biomechanical study","volume":"66","author":"Duhaime","year":"1987","journal-title":"J Neurosurg"},{"issue":"1","key":"2021121009435917700_B3","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1542\/peds.108.1.206","article-title":"Shaken baby syndrome: rotational cranial injuries\u2014technical report","volume":"108","author":"American Academy of Pediatrics, Committee on Child Abuse and Neglect","year":"2001","journal-title":"Pediatrics"},{"issue":"2","key":"2021121009435917700_B4","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.neurad.2007.01.124","article-title":"Non-accidental brain trauma in infants: diffusion imaging, contributions to understanding the injury process","volume":"34","author":"Zimmerman","year":"2007","journal-title":"J Neuroradiol"},{"issue":"9329","key":"2021121009435917700_B5","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0140-6736(02)09563-6","article-title":"Non-accidental head injury in children: gathering the evidence","volume":"360","author":"Stoodley","year":"2002","journal-title":"Lancet"},{"issue":"6","key":"2021121009435917700_B6","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s00247-009-1212-y","article-title":"Assessment of the nature and age of subdural collections in nonaccidental head injury with CT and MRI","volume":"39","author":"Vezina","year":"2009","journal-title":"Pediatr Radiol"},{"issue":"7442","key":"2021121009435917700_B7","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1136\/bmj.328.7442.719","article-title":"The evidence base for shaken baby syndrome","volume":"328","author":"Geddes","year":"2004","journal-title":"BMJ"},{"issue":"5","key":"2021121009435917700_B8","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s00247-008-1136-y","article-title":"Nonaccidental trauma: clinical aspects and epidemiology of child abuse","volume":"39","author":"Hobbs","year":"2009","journal-title":"Pediatr Radiol"},{"key":"2021121009435917700_B9","volume-title":"Diagnostic Imaging of Child Abuse","author":"Kleinman","year":"1998","edition":"2nd ed"},{"issue":"7","key":"2021121009435917700_B10","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/j.1651-2227.1999.tb00034.x","article-title":"Magnetic resonance imaging in acute non-accidental head injury","volume":"88","author":"Barlow","year":"1999","journal-title":"Acta Paediatr"},{"issue":"2","key":"2021121009435917700_B11","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1542\/peds.2006-0130","article-title":"Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography","volume":"118","author":"Tung","year":"2006","journal-title":"Pediatrics"},{"issue":"12","key":"2021121009435917700_B12","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.chiabu.2005.05.003","article-title":"Perpetrator accounts in infant abusive head trauma brought about by a shaking event","volume":"29","author":"Biron","year":"2005","journal-title":"Child Abuse Negl"},{"issue":"3","key":"2021121009435917700_B13","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/01.paf.0000164228.79784.5a","article-title":"Case analysis of brain-injured admittedly shaken infants: 54 cases, 1969\u20132001","volume":"26","author":"Leestma","year":"2005","journal-title":"Am J Forensic Med Pathol"},{"issue":"5","key":"2021121009435917700_B14","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1001\/archpedi.158.5.454","article-title":"P. Analysis of perpetrator admissions to inflicted traumatic brain injury in children","volume":"158","author":"Starling","year":"2004","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"pt 7","key":"2021121009435917700_B15","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1093\/brain\/124.7.1299","article-title":"Neuropathology of inflicted head injury in children: II. Microscopic brain injury in infants","volume":"124","author":"Geddes","year":"2001","journal-title":"Brain"},{"issue":"3","key":"2021121009435917700_B16","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1080\/02688690220148824","article-title":"Biomechanics and neuropathology of adult and pediatric head injury","volume":"16","author":"Ommaya","year":"2002","journal-title":"Br J Neurosurg"},{"issue":"5","key":"2021121009435917700_B17","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1542\/peds.2006-3111","article-title":"Mechanisms, clinical presentations, injuries, and outcomes from inflicted versus noninflicted head trauma during infancy: results of a prospective, multicentered, comparative study","volume":"119","author":"Hymel","year":"2007","journal-title":"Pediatrics"},{"issue":"6","key":"2021121009435917700_B18","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.chiabu.2008.09.008","article-title":"Non-accidental head injury in New Zealand: the outcome of referral to statutory authorities","volume":"33","author":"Kelly","year":"2009","journal-title":"Child Abuse Negl"},{"issue":"5","key":"2021121009435917700_B19","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2005-0811","article-title":"Findings in older children with abusive head injury: does shaken-child syndrome exist?","volume":"117","author":"Salehi-Had","year":"2006","journal-title":"Pediatrics"},{"issue":"2","key":"2021121009435917700_B20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1542\/peds.2007-2312","article-title":"Clinicians' description of factors influencing their reporting of suspected child abuse: report of the child abuse reporting experience study research group","volume":"122","author":"Jones","year":"2008","journal-title":"Pediatrics"},{"key":"2021121009435917700_B21","unstructured":"Penal code, Article 223\u20136. Available at: http:\/\/195.83.177.9\/upl\/pdf\/code_33.pdf. Accessed June 15, 2010"},{"issue":"5","key":"2021121009435917700_B22","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2005-0296","article-title":"Child deaths resulting from inflicted injuries: household risk factors and perpetrator characteristics","volume":"116","author":"Schnitzer","year":"2005","journal-title":"Pediatrics"},{"issue":"2","key":"2021121009435917700_B23","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1542\/peds.95.2.259","article-title":"Abusive head trauma: the relationship of perpetrators to their victims","volume":"95","author":"Starling","year":"1995","journal-title":"Pediatrics"},{"issue":"5","key":"2021121009435917700_B24","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1542\/peds.2009-0408","article-title":"Abusive head trauma in infants and children","volume":"123","author":"Christian","year":"2009","journal-title":"Pediatrics"},{"issue":"4","key":"2021121009435917700_B25","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2007-2485","article-title":"Variability in expert assessments of child physical abuse likelihood","volume":"121","author":"Lindberg","year":"2008","journal-title":"Pediatrics"},{"issue":"5","key":"2021121009435917700_B26","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1542\/peds.2009-0558","article-title":"Diagnostic imaging of child abuse","volume":"123","author":"American Academy of Pediatrics, Section on Radiology","year":"2009","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/3\/546\/846453\/zpe00910000546.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/3\/546\/846453\/zpe00910000546.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T21:42:08Z","timestamp":1639172528000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/126\/3\/546\/66177\/Abusive-Head-Trauma-Judicial-Admissions-Highlight"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9,1]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2010,9,1]]},"published-print":{"date-parts":[[2010,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2009-3647","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9,1]]}}}