Author(s): Talbert DG
Introduction In the Shaken Baby Syndrome (SBS) concept subdural bleeding is attributed to tearing of bridging veins at the Dural/Sagital Sinus junction resulting, from excessive tension during shaking of the infant by the carer. The brain is assumed to rotate within the skull, stretching these veins until they get pulled out of their attachments. The critical region where relative skull/br ain movement would take place is across the subarachnoid space. This present study was to establish the mechanical factors involved. The Hypothesis The basis of the Shaken Baby Syndrome concept is that intracranial bleeds arise from relative movement of brain and skull during shaking. No mention is made of the “cob - web” of fine sheets and columns in the subarachnoid space stitching the arachnoid and pia maters together in a manner that would severely limit that movement. Without consideration of this fact or the SBS concept is invalid. Evaluation of Hypothesis It was found that the classic model of the brain floating in cerebrospinal fluid, located by the bridging veins was incorrect. The apparently empty space is actually filled with a cobweb of collagen r einforced “Trabeculae” which are too thin to register on ultrasound or MRI machines. It is these trabeculae that locate the brain within the cerebrospinal fluid. The bridging veins are also supported in this cobweb. Moreover, the viscous effects of this co mbination of fluid and hundreds of trabeculae appears to provide a hydro - mechanical shock absorber system. Conclusion The present SBS hypothesis does not even mention the trabecular structure. The trabecular network in the subarachnoid space appears to hav e evolved to counter precisely the brain/skull movement that the SBS concept depends on. Until that effect is evaluated the SBS concept must be considered invalid.