First discovered in 1971 by pediatric neurosurgeon Norman Guthkelch, who linked head injuries in young children to violent shaking, Shaken Baby Syndrome remains “the most controversial area in forensic pathology,” according to Canadian pathologist Dr Evan Matshes.
The diagnosis is difficult to ascertain, and in Canada, disgraced pathologist Charles Smith caused the incarceration of numerous parents by falsely accusing them of abuse.
In a recently published study in the National Association of Medical Examiners’ journal, Academic Forensic Pathology, a North American team of researchers in Florida, Texas, and Alberta conducted autopsies on 35 babies.
Researchers found the actual injury can be traced to an infant’s neck, where ‘cervical spine nerve roots’ in effect smother a baby’s diaphragm, reports an NPR news blog. In the first year of life, infants have such weak chest muscles that they use the diaphragm to breathe much more than an older child or adult who has developed chest muscles.
When babies are shaken, the nerve roots get injured, which knocks out the diaphragm, leading to the brain injuries that are seen in children who are shaken — so it’s the original injury to nerves in the neck that cause death, not the brain injury.
“It was one of those ‘wow’ moments,” said Matshes of the discovery. Some pathologists are already using the neck-autopsy technique, he said, and hopes other will, despite the time it requires.
This particular autopsy of the neck can take more than three weeks of work with an acid bath, and in the investigation of an infant death, he acknowledged, that extra time can be “frustrating for everyone involved.”