New research by Canadian pathologist Evan Matshes challenges the opinion that death from shaking is due to brain trauma characterized by the “traditional triad” of injuries: subdural bleeding, retinal bleeding and brain swelling.
His research, published in the July 2011 edition of the journal of American Forensic Pathology (available here: Shaken infants die of neck trauma, not of brain trauma), shows that death from shaking could occur due to neck injury, evidenced by bleeding in the nerve roots in a particular region of the spinal column.
Matshes’s research gives a new explanation for how death from shaking occurs: the C3, C4, C5 region of the spinal column controls the diaphragm. Damage to the nerve roots in this area could paralyze the diaphragm and stop the baby from breathing.
EMILY BAZELON in New Evidence on Shaken Baby Syndrome, the blog of the New York Times Magazine explains the findings:
In investigating the deaths of 35 babies, Matshes did autopsies in a new way. The usual practice is to dissect only part of the spinal column. Matshes dissected the spine down through the neck and into the nerve roots. What he found was striking. He looked at the spinal columns of 12 babies whose history showed evidence of injury from hyperflexion — in other words, severe whiplash, from shaking or, for example, from a car accident.
In all 12, he found bleeding in the nerve roots of the part of the spinal column called C3, C4 and C5. Matshes also dissected the spinal columns of 23 babies for whom there was not solid evidence of an injury from whiplash. (Most of the babies in this group died of SIDS, or from being smothered by an adult who was sleeping with them.) Only one baby in this group of 23 had bleeding in the same C3, C4, C5 region, and that child’s history, while inconclusive, made shaking a distinct possibility.