{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T01:59:07Z","timestamp":1786413547722,"version":"build-2736575974"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1987,3]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Because a history of shaking is often lacking in the so-called \u201cshaken baby syndrome,\u201d diagnosis is usually based on a constellation of clinical and radiographic findings. Forty-eight cases of infants and young children with this diagnosis seen between 1978 and 1985 at the Children's Hospital of Philadelphia were reviewed. All patients had a presenting history thought to be suspicious for child abuse, and either retinal hemorrhages with subdural or subarachnoid hemorrhages or a computerized tomography scan showing subdural or subarachnoid hemorrhages with interhemispheric blood. The physical examination and presence of associated trauma were analyzed; autopsy findings for the 13 fatalities were reviewed. All fatal cases had signs of blunt impact to the head, although in more than half of them these findings were noted only at autopsy. All deaths were associated with uncontrollably increased intracranial pressure.<\/jats:p>\n<jats:p content-type=\"fine-print\">Models of 1-month-old infants with various neck and skull parameters were instrumented with accelerometers and shaken and impacted against padded or unpadded surfaces. Angular accelerations for shakes were smaller than those for impacts by a factor of 50. All shakes fell below injury thresholds established for subhuman primates scaled for the same brain mass, while impacts spanned concussion, subdural hematoma, and diffuse axonal injury ranges. It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.<\/jats:p>","DOI":"10.3171\/jns.1987.66.3.0409","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:11:54Z","timestamp":1241799114000},"page":"409-415","source":"Crossref","is-referenced-by-count":569,"title":["The shaken baby syndrome"],"prefix":"10.3171","volume":"66","author":[{"given":"Ann-Christine","family":"Duhaime","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Gennarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence E.","family":"Thibault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek A.","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan S.","family":"Margulies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Wiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Principles of Neurology","first-page":"387","author":"Adams","year":"1981"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/jns.1981.54.2.0170","article-title":"Diffuse cerebral swelling following head injuries in children: the syndrome of \u201cmalignant brain edema.\u201d","volume":"54","author":"Bruce","year":"1981"},{"key":"b3","series-title":"Am J Dis Child","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1001\/archpedi.1972.02110140011001","article-title":"On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation.","volume":"124","author":"Caffey","year":"1972"},{"key":"b4","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1542\/peds.54.4.396","article-title":"The whiplash shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain damage and mental retardation.","volume":"54","author":"Caffey","year":"1974"},{"key":"b5","series-title":"J Clin Pathol","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1136\/jcp.37.10.1095","article-title":"Primary brain trauma in non-accidental injury.","volume":"37","author":"Calder","year":"1984"},{"key":"b6","series-title":"Neurosurgery.","first-page":"1531","article-title":"Biomechanics of head injury","author":"Gennarelli","year":"1985"},{"key":"b7","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1002\/ana.410120611","article-title":"Diffuse axonal injury and traumatic coma in the primate.","volume":"12","author":"Gennarelli","year":"1982"},{"key":"b8","series-title":"Br Med J","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1136\/bmj.2.5759.430","article-title":"Infantile subdural haematoma and its relationship to whiplash injuries.","volume":"2","author":"Guthkelch","year":"1971"},{"key":"b9","series-title":"Childs Brain","first-page":"229","article-title":"Traumatic mechanisms of head injury in child abuse.","volume":"10","author":"Hahn","year":"1983"},{"key":"b10","series-title":"Head Injury: Basic and Clinical Aspects.","first-page":"1","article-title":"A holistic view of head injury including a new clinical classification","author":"Langfitt","year":"1982"},{"key":"b11","series-title":"Arch Pathol","first-page":"298","article-title":"Morphology of brain lesions from blunt trauma in early infancy.","volume":"87","author":"Lindenberg","year":"1982"},{"key":"b12","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/S0196-0644(84)80571-5","article-title":"Shaken baby syndrome: a review of 20 cases.","volume":"13","author":"Ludwig","year":"1984"},{"key":"b13","series-title":"Childs Brain","first-page":"225","article-title":"Cerebral injury in child abuse: a changing profile.","volume":"7","author":"McClelland","year":"1980"},{"key":"b14","series-title":"Pediatr Ann","doi-asserted-by":"publisher","first-page":"882","DOI":"10.3928\/0090-4481-19831201-06","article-title":"Craniocerebral trauma in the child abuse syndrome.","volume":"12","author":"Merten","year":"1983"},{"key":"b15","series-title":"Dev Med Child Neurol","first-page":"826","article-title":"The neurological sequelae of non-accidental injury.","volume":"16","author":"Sarsfield","year":"1974"},{"key":"b16","series-title":"Proceedings of the Fourth Experimental Safety Vehicle Conference.","article-title":"Biomechanics of diffuse brain injuries","author":"Thibault","year":"1985"},{"key":"b17","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1148\/130.3.687","article-title":"Computed tomography of craniocerebral injury in the abused child.","volume":"130","author":"Zimmerman","year":"1979"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/66\/3\/article-p409.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/66\/3\/article-p409.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/66\/3\/article-p409.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T16:26:49Z","timestamp":1658680009000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/66\/3\/article-p409.xml"}},"subtitle":["A clinical, pathological, and biomechanical study"],"short-title":[],"issued":{"date-parts":[[1987,3]]},"references-count":17,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1987.66.3.0409","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1987,3]]}}}