The New Zealand Medical Journal 117(1201), 10 September 2004

This article aims to further identify features which may assist medical staff to make a distinction between accidental and non-accidental injury. The authors highlight that in Auckland, a major cause of death and disability in children under 2 years of age presenting at hospital, is subdural haemorrhage (SDH), or 'shaken baby syndrome'. Certain characteristics aid workers to identify that child abuse is the major cause for these non-accidental traumas. This research employed a retrospective analysis of the medical records of children admitted to Auckland or Starship hospitals with SDH or retinal haemorrhage. Sixty-four cases of SDH were identified, of which 41 were from non-accidental injury. The remaining 23 cases were accidental. Mortality rates were far higher in the non-accidental group, and there were comparatively more Māori children in the non-accidental injury group. The article provides a discussion of mechanisms (alleged) of injury, clinical presentations, ethnicity, radiological findings, and outcomes for the children. Limitations are discussed, and the author suggests areas for future research.