As I've previously written, North Carolina remains a place where abusive head trauma or intentional head trauma (formerly known as shaken baby syndrome) is misdiagnosed.
It is certainly not disputed that children are sometimes intentionally abused, and that this can have traumatic long term effects. It is, however, a matter for dispute about whether the two indicia – retinal hemorrhaging, subdural hematomas – therefore mean that the injuries must have been a result of abuse.
New literature is now making its way into the field indicating that quite a lot about what child abuse experts thought they knew about retinal hemorrhaging and subdural hematomas is not in fact true.
A case in which a child has RH and SDH, but little or no bruising, and no injuries to the neck, may very well be a case in which there has been no child abuse at all.
How, does RH and SDH appear in an otherwise healthy child? Some research indicates that as many as 4 in 10 babies may be born with undetected SDH, which goes unnoticed because it is asymptomatic. That's because the most traumatic event is passage through the birth canal. The RH may also occur from time to time, either because of rapid changes in air pressure, or because there has been an accidental fall that has triggered RH and then triggers a second bleed of the latent SDH.