Spread of “triad diagnostics” in suspected Shaken Baby Syndrome

We describe here possibly the first two cases of alleged Shaken Baby Syndome (SBS) in Poland, based solely on “triad findings” (encephalopathy symptoms, subdural hemorrhage/SDH, and retinal hemorrhages/RH), but without signs of relevant trauma. Case #1, a 7-week-old infant girl, is suggested to represent a case of rebleeding in a birth-related SDH. In case #2, a 13-week-old infant boy, we claim that the triad findings were related to benign external hydrocephalus (BEH). Unjustified belief that triad findings are always caused by violent shaking may, apart from the obvious legal and social effects, in case #2 also have contributed to delayed adequate treatment of increased intracranial pressure and subsequent signs of permanent brain damage. We discuss also the traditional SBS hypothesis and its lack of solid scientific evidence, and the uneven geographical acceptance of and belief in this unvalidated hypothesis. • Two cases of suspected Shaken Baby Syndrome are presented, both misdiagnosed. • The lack of reliability of the “triad diagnostic method” is emphasized. • The most common cause of triad findings is probably BEH/BESS. • Both over- and underdiagnosis of suspected abuse can have disastrous effects.