Part I, Section I

Prosecutors build murder cases on disputed Shaken Baby Syndrome diagnosis

Interview

Mother acquitted of shaking a baby: ‘I would have committed suicide’

Part I, Section II

Doctors who defend shaking diagnosis dismiss scientific challenges

Interview

Prosecutor: ‘The public should know that this can kill’

Graphic

The unsettled science of Shaken Baby Syndrome

Part I, Section III

Mother released from prison: ‘It hurts too bad to remember’

Video

After five years in prison, a young mother is set free

Part I, Section IV

In Maryland, a baby collapses and a babysitter is blamed

Part I, Section V

Prosecutor to jurors: ‘Healthy babies just don't die’

Part I, Section VI

But that year, the case took a significant turn.

Interview

Babysitter once sentenced to 20 years in prison: ‘I’m not gonna say that I killed somebody’

Graphic

A breakdown of the dismissed cases

Graphic

Map: Parents and caregivers accused of shaking nationwide

Interview

Former medical examiner: ‘Alleged cases of pure shaking are unusual’

Part II, Section I

Doctors who diagnosed Shaken Baby Syndrome now defend the accused

Interview

Doctor who helped introduce the hypothesis behind Shaken Baby Syndrome: ‘I don’t think innocent people should be in jail’

Part II, Section II

A child abuse diagnosis raises questions, doubts

Interview

Accident reconstruction specialist: ‘We need to apply the science’

Part II, Section III

Engineers: Falls could be more dangerous than shaking

Graphic

A biomechanical look at shaking

Graphic

How much acceleration can be generated by shaking a 22-pound crash-test dummy

Part II, Section IV

Doctor: ‘What could be right about getting it wrong?’

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Shaken science

A disputed diagnosis imprisons parents

The unsettled science of Shaken Baby Syndrome

For more than a decade, a growing movement of doctors and engineers has questioned the science behind Shaken Baby Syndrome, long considered a serious public health threat. Testing has been unable to conclusively show if violent shaking can produce the conditions often linked to the diagnosis -- bleeding and swelling in the head and bleeding in the back of the eyes -- and doctors have found that accidents and a series of diseases can in some cases produce identical conditions in infants. Doctors who support the diagnosis, however, say that it has been validated by years of clinical work, research and confessions from parents and caregivers. Here is how those doctors describe the impact of violent shaking:

Retinal hemorrhaging

Young children have proportionally bigger and heavier heads than adults and weaker neck muscles. Their brains are also immature and more susceptible to injuries.

During violent shaking, blood vessels in

a child's brain may break, causing widespread bleeding in the back of the eyes.

Pediatricians say they have

found retinal hemorrhages

in 85 percent of

babies who

were shaken.

Cornea

Pupil

Retina

Bleeding

Brain swelling

Acceleration and deceleration changes cause swelling of the brain. This damage changes the shape of the brain and triggers the loss of neurons, very similar to conditions that have been observed in boxers.

Subdural

hematoma

Severe shaking causes

the child’s head to move violently back and forth.

Gyri

Flattened

gyri

Ventricles

Compressed

ventricles

Subdural hematoma

When a child is shaken or thrown, the head twists and whips back and forth, creating shearing forces in the brain. This can cause tears to the bridging veins and nerve cells and trigger bleeding and swelling.

1

2

3

Skin

Skull

Subdural

space

Cerebral

cortex

1. Blood vessels run between the surface of the brain and the cerebral cortex. 2. When the head is vigorously shaken, the bridging veins are stretched beyond their elasticity and break. 3. Blood fills the subdural space.

Young children have proportionally bigger and heavier heads than adults and weaker neck muscles. Their brains are also immature and more susceptible to injuries.

Retinal hemorrhaging

Cornea

Pupil

During violent shaking, blood vessels

in a child's brain may break, causing

widespread bleeding in the back of

the eyes. Pediatricians say they have

found retinal hemorrhages

in 85 percent of babies who

were shaken.

Retina

Bleeding

Brain swelling

Acceleration and deceleration changes cause swelling of the brain. This damage changes the shape of the brain and triggers the loss

of neurons, very similar to conditions that have been observed

in boxers.

Subdural

hematoma

Gyri

Flattened

gyri

Ventricles

Compressed

ventricles

Subdural hematoma

Skin

When a child is shaken or thrown, the head twists and whips back and forth, creating shearing forces in the brain. This can cause tears to the bridging veins and nerve cells and trigger bleeding

and swelling.

Skull

Subdural

space

Cerebral

cortex

1

2

3

1. Blood vessels run between the surface of the brain and the cerebral cortex. 2. When the head is vigorously shaken, the bridging veins are stretched beyond their elasticity and break. 3. Blood fills the subdural space.

Young children have proportionally bigger and heavier heads than adults and weaker neck muscles. Their brains are also immature and more susceptible to injuries.

Retinal hemorrhaging

During violent shaking, blood vessels

in a child's brain may break, causing

widespread bleeding in the back of

the eyes. Pediatricians say they have

found retinal hemorrhages

in 85 percent of babies who

were shaken.

Cornea

Pupil

Retina

Bleeding

Brain swelling

Acceleration and deceleration changes cause swelling of the brain. This damage changes the shape of the brain and triggers the loss of neurons, very similar to conditions that have been observed in boxers.

Subdural

hematoma

Flattened

gyri

Gyri

Ventricles

Compressed

ventricles

Subdural hematoma

When a child is shaken or thrown, the head twists and whips back and forth, creating shearing forces in the brain. This can cause tears to the bridging veins and nerve cells and trigger bleeding and swelling.

Skin

Skull

Subdural

space

Cerebral

cortex

1

2

3

1. Blood vessels run between the surface of the brain and the cerebral cortex. 2. When the head is vigorously shaken, the bridging veins are stretched beyond their elasticity and break. 3. Blood fills the subdural space.

SOURCES: Child abuse pediatrician Robert W. Block, past president of the American Academy of Pediatrics, American Association of Neurological Surgeons, National Center on Shaken Baby Syndrome.

GRAPHIC: Alberto Cuadra/The Washington Post