Stroke or Shaken Baby Syndrome

[Geej]

Can a infant stroke be misadiagnosed as shaken baby syndrome? -- my poor cousin has been accused of this and his child taken from him after an opthamologist made this diagnosis at the hospital.  He and his wife would never harm their baby nor his older sister.  They waited so long for children.  One child was lost to miscarriage and another died of birth defects shortly after being born and never came home from the hospital.  They truly love their children and would never have harmed them.  They have retained the services of attorneys to fight this -- am  interested in hearing of other cases and from neurologists who might be able to help clear this up and return the children to their parents.

[CCF Neuro[P] MD, RPS]

Dear Geej:

Sorry to hear about your cousin's child.  Actually, the difference between a stroke and shaken baby syndrome is distinct enough that it would likely not be mixed up.  A stroke could not give a baby retinal findings, as these only occur through trauma.  This would be especially true if there was evidence from previous broken bones or bruises in areas not exposed to trauma.  

Sincerely,

CCF Neuro MD

[Geej]

There are no bruises or broken bones.  No signs of trauma.

[Carlos]

what is the differential diagnosis of the retinal findings, in the absence of previous broken bones or bruises?  just curious.  

i know that sometimes bleeding disorders can present in much the same way as physical abuse because of the bruising.  but are there conditions which mimic the retinal findings in shaken baby syndrome?

thanks for this wonderful forum

carlos from kansas

[Carlos]

what is the differential diagnosis of the retinal findings, in the absence of previous broken bones or bruises?  just curious.  

i know that sometimes bleeding disorders can present in much the same way as physical abuse because of the bruising.  but are there conditions which mimic the retinal findings in shaken baby syndrome?

thanks for this wonderful forum

carlos from kansas

[CCF Neuro[P] MD, RPS]

Dear Carlos:

Actually the only differential diagnosis is accidental injury and rotational forces they incur.  The retinal and optic nerve sheath hemorrhages are not found in stroke.

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Carlos:

Actually the only differential diagnosis is accidental injury and rotational forces they incur.  The retinal and optic nerve sheath hemorrhages are not found in stroke.

CCF Neuro MD

[MB]

Carlos, I'm not a doctor. But I'm wondering whether anyone has considered that the baby's sibling might have caused the shaken baby syndrome? Perhaps the toddler had access to the baby while he was in a Jolly Jumper or something similar?

I also wonder whether the baby should be checked for a bleeding disorder or for juvenile macular degeneration (congenital). Perhaps there is something going on here besides shaken baby syndrome. As well as an attorney, I think your cousin should try to consult a leading pediatric neuro-opthalmologist and perhaps a hematologist. Good luck!

[Gloria]

Geej--I live in Nashville and we had a well-publicized case involving a physician and her military husband being accused of "shaken-baby syndrome."  The couple was able to afford a very good legal defense--Johnny Cochran (O.J. Simpson case).  Actually, his services were really not necessary because the baby suffered from a rare, congenital gastrointestinal/liver disorder that caused him to bleed easily.  The parents did not achieve immediate results in their quest to get their child returned and their name cleared, but it did happen over time.  I cannot think of the name of the couple, but the case was against Vanderbilt Medical Center.  It occurred at least a year ago.  I hope that helps and I hope and pray that you are correct in assuming that your cousin is totally innocent of the accusations against them.