Shaken Baby Syndrome Science


Diseases & conditions that mimic shaken baby syndrome

In many cases, medical findings that are typically found in abuse have accidental or medical explanations.

Benign Extra-Axial Collections (BEAC)

There is a well-recognized condition in children that has arisen in over a dozen of the cases in which Mark Freeman has been involved. This condition exists where there is a little extra space between the child’s brain and skull that stretches the veins that traverse or bridge the space between the surface of the brain and the big draining vein called the superior sagittal sinus (these are often called “bridging veins”). It is not known what causes this condition, but birth trauma has been suggested as one potential cause, and the condition often manifests itself as lethargy, vomiting or seizures typically in the two to six-month old range. Head CT scans and brain MRIs often show a chronic subdural or subarachnoid fluid collection and some acute subdural hemorrhage. Child abuse “experts” often leap to the conclusion that the acute subdural hemorrhage was due to abusive trauma that caused the child’s presenting symptoms and the chronic fluid collection is evidence of prior episodes of abusive head trauma. In many cases, the child abuse “expert” failed to investigate and/or dismissed the child’s traumatic birth, or an accidental bump, that later grew into larger subdural and/or subarachnoid collections that ultimately triggered the child’s symptoms. Mark Freeman has successfully defended many of these cases.

Short Falls

At one time it was falsely believed that short falls could not cause subdural hemorrhage, retinal hemorrhage and brain injury or even death. More recent research has disproven this false belief. We now know that short falls can transmit greater force to a child’s head than human shaking. However, some child abuse “experts” continue to assert, and testify, that short falls cannot cause subdural hemorrhage, retinal hemorrhage and/or brain injury. They dismiss accidental falls from a caregiver’s arms, from a bed, changing table or couch, or seemingly minor impact, as a history that is not consistent with the child’s injuries. Mark Freeman has experience and success challenging these so-called child abuse experts with the science and literature regarding short falls.

Birth trauma

Birth trauma is known to routinely cause subdural hemorrhage and retinal hemorrhage births, including births via cesaerian section. Child abuse “experts” often fail to investigate the child’s birth, or simply dismiss a traumatic birth as irrelevant to a young infant who has subdural and/or retinal hemorrhage. Mark Freeman has been involved in multiple cases where birth trauma contributed to the findings that child abuse “experts” claimed were abusively inflicted.

Bleeding Disorders

Bruising, subdural hemorrhage and retinal hemorrhage are recognized to occur from minor or no trauma when a child has a bleeding disorder. In many cases, however, the doctors stopped looking for any bleeding disorder once they began to suspect abuse. Standard screening tests for blood disorders do not rule out the rarer bleeding disorders, or even more common mild platelet disorders. Child abuse “experts” frequently (and incorrectly) dismiss thrombosed or clotted veins as a potential cause of subdural and retinal bleeding. Mark Freeman has had cases where the doctors failed to perform the testing necessary to identify a coagulation problem that provided an explanation for the child’s medical findings. In some cases, after Mark Freeman got involved, bleeding/clotting disorders were identified leading to favorable outcomes in his clients’ criminal and family court cases.

Collagen Disorders

Collagen disorders such as Osteogenesis Imperfecta, Ehlers Danlos Syndrome, and others are recognized to make patients susceptible to bone fragility fractures, subdural hemorrhage, retinal hemorrhage and bruising. Child abuse experts often dismiss collagen disorders, or never even test for or consider them. Mark Freeman has been involved in multiple cases where collagen disorders have been identified in children providing an explanation for the child’s findings. Genetic testing for collagen disorders can be misunderstood as having “ruled out” the disease because no genetic defect was identified.

Vitamin deficiencies

Vitamin K deficiency is well-recognized to cause subdural hemorrhage. Vitamin d deficiency is associated with rickets and bone fragility. Mother’s are often vitamin d deficient leading to deficient infants. Exclusively breast-fed children are often found to be vitamin d deficient. Mark Freeman has encountered several cases where vitamin d deficiency contributed to the medical findings alleged to have been abusively inflicted.

Other Medical Conditions

There is a long list of medical conditions that can make a child susceptible to subdural hemorrhage and retinal hemorrhages. These include copper disorders such as Menkes disease, metabolic disorders such as Glutaric Aciduria and other genetic disorders. Child abuse pediatricians frequently claim they have “ruled out” a genetic cause of the findings when no meaningful genetic workup has been performed. Certain infections can also trigger findings that are misinterpreted as having been caused by child abuse. Mark Freeman has experience with cases where these other medical conditions were misinterptreted as the cause of symptoms often seen in child abuse.

Note: No attorney can guarantee the outcome of any case, and an attorney’s success in other prior cases is no guarantee in the outcome of any future cases.