Retinal Haemorrhages.

NOTE:- All names and dates have been changed apart from in extracts from medical literature.

RETINAL HAEMORRHAGES.

Consider this extract from ‘CLINICAL EXAMINATION’, page 384. “ The use of the ophthalmoscope is dealt with in Chapter 11. The difficulties of this examination in children are often considerable. To maintain the young child’s gaze in a fixed direction it is usually necessary for a second person to arrange some diversion which for the child has an element of expectancy about it. The examiner, after positioning the patient may say ,’Tell me when the torch flashes’, the torch being held in an appropriate position by a helper who may be mother or nurse, or ‘Tell me how many fingers nurse has up – how many now?,’ the nurse changing the numbers of fingers and thus maintaining the child’s attention. With younger children sedation may be necessary and in certain circumstances even a general anaesthetic may be required.

Extract from Medical Literature.

“They [Retinal haemorrages] are also reported to occur in a percentage of new born infants e.g. 14% in a study by Sezen:(……) and 20% Small(…) who found evidence of retinal haemorrhages but no evidence of intracranial injury on Magnetic Resonance Scanning subsequently. These retinal haemorrhages resolve within a short time after birth e.g. 10 days…….”.

Here is an argument stating that there is evidence of  ‘spontaneous’ retinal haemorrhages’ in a significant number of the newly born, but that these normally clear in 10 days.

It is evident from the above extract that retinal haemorrhages are commonly caused by extremely minor ‘trauma’ and are not particularly indicative of a shaking injury.

One should remember that blood circulates by surges in pressure. Restriction of the veins leading away from any part of the body cause excessive pressure surges in that part of the body.

Place an elastic band on a finger or around your wrist and this excessive pressure can be clearly felt in the extremity. This is because the elastic band only restricts the veins carrying blood away from the affected part, but the arterial blood flowing into the hand or finger is not restricted. If the restriction is long lasting then serious damage can be caused to that part of the body. If one considers a blood pressure cuff being gradually inflated over a period of weeks or months, the pressure in the veins will gradually build up until the pressure exerted by the cuff is sufficient to stop the blood flowing. If then left in this state serious damage would be caused.

In regard to retinal haemorrhages, if the veins leading from the eye are restricted, as can happen in hydrocephalus, there can be either a rapid or a gradual reduction in the blood flow. As the veins themselves require blood to sustain themselves in good working order, lack of blood flow weakens them. The areas of the eye being served by the capillaries are also damaged due to lack of blood flow. The increased pressure pulses remain but no fresh blood is being supplied. After a while the weakest veins, i.e. the capillaries in the eye, or the part being supplied, break down due to the increased pressure pulses and the poor condition.

It is evident therefore that there can be no precise time scale for the development of retinal haemorrhages.

My Own Retinal Haemorrhage.

The year following this court case I suffered a retinal haemorrhage.

I was driving out of a city centre when a black spot appeared in my right eye. This quickly changed into a black snakelike shape and then into multiple treelike branches, and finally a deep red haze that completely closed all vision in my right eye.

Luckily, having worked on the above case I immediately understood what had happened. I asked a passer-by for the location of a doctor, and within 20 minutes I was on my way to hospital by ambulance. A week later I had the first laser treatment.

Discussing the problem with the surgeon, she said that I must have an infection or I must have had a bang to my head in the last couple of days. Tests showed no signs of infections, and I certainly had no bangs to my head in the last few days.

However, I did have a severe bang to my head 6 weeks before, when I bent down to stroke our  labrador dog who jumped up to lick me at the same time, causing a collision of heads. Both of us ended up on the floor stunned for a few minutes.

For the weeks following, from dusk onwards I was aware of flashing lights in front of my right eye. These continued for the 6 weeks until the retinal haemorrhage occured. I went into hospital for laser treatment for the retinal haemorrhage about a week to 10 days later.

The surgeon was adamant that the dog incident was too early to have caused my retinal haemorrhage, but could not suggest an alternative hypothesis.

Author – Brian Williams

Shaken Baby Syndrome – Preliminaries

You will not find much humour in this series of posts. The original report on which it based was produced while I was in a state of anger, over many months, at the lack of honesty and professionalism by the prosecution.

Syndrome – From Google.

1. A group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms.
2. A characteristic combination of opinions, emotions or behavior.

In the ‘Shaken Baby Syndrome‘ the original symptom responsible for the name was damage done to the upper arms of a  baby or child. This  could be bruising, breakages or shoulder dislocations, or a combination of these. Later, in some cases, damage was discovered to the child’s neck. These symptoms should normally lead to the suspicion of Shaken Baby Syndrome.

This type of injury is not, in itself, proof of the baby being shaken. Some-one catching a falling child could accidentally inflict the same injuries. Bruising on one side of one arm alone would indicate the possibilty of a falling injury.

A falling child could suffer a single arm bruising, neck injury and broken arm. A child falling downstairs could have all of the above injuries.

Neck injuries without damage to the upper arms should indicate that  ‘Shaken Baby Syndrome’ does not apply.

‘None shaking’ neck injuries would show bruising or cuts to the head or neck.

Now consider the following extract from Google

Shaken baby syndrome (SBS) is a triad of medical symptoms: subdural haematoma, retinal hemorrhage, and brain swelling from which doctors, consistent with current medical understanding, infer child abuse caused by intentional shaking. In a majority of cases there is no visible sign of external trauma.

SBS is often fatal and can cause severe brain damage, resulting in lifelong disability. Estimated death rates (mortality) among infants with SBS range from 15% to 38%; the median is 20%–25%. Up to half of deaths related to child abuse are reportedly due to shaken baby syndrome. Nonfatal consequences of SBS include varying degrees of visual impairment (including blindness), motor impairment (e.g. cerebral palsy) and cognitive impairments.

Notice the complete lack of any mention of arm injuries or neck injuries.

A few years ago I was requested to carry out an investigation into the medical evidence presented by the prosecution in a case claiming that the parents had caused life threatening injuries to their infant son by seriously shaking him and throwing onto the  floor or onto a hard object.

The prosecution team (against the parents) included 12 consultants and 6 Social Services personnel. The defense team proposed by the Social Services, comprised the parents, an inexperienced solicitor and a medical consultant who was later revealed as a professional prosecution witness in this type of case. (The social Services admitted that they had to work in accordance the charges, and spent most of their time attempting to get the parents to admit their guilt.) The parents had been told by the Social Services that they must not tell any-one about what was happening, but the parents had more sense and told their parents.

The family then decided that  they would have to handle the defense themselves, and began collecting published medical information. I became involved when I was asked to draft a letter for them repudiating some legal point.

After many months I did manage to prove that the parents were not guilty, and that the damage occurred at the hospital.

What was the damage?

Subdural haematomas.

Retinal Haemorrhages.

Brain Swelling.

So we had the situation that the child had all the symptoms claimed by the prosecution to prove ‘Shaken Baby Syndrome, but I could prove that the damage actually occurred at the hospital. This throws the validity of all the evidence required for justification of ‘shaken baby’ trials into serious doubt.

The interesting point about all this is that the prosecution was instigated and controlled by the people responsible for the injuries

The medical use of the Shaken Baby Syndrome has become a ( as stated under Syndrome –  category 2),

“A characteristic combination of opinions, emotions or behavior.”

Unfortunately this relates to medical professionals, not patients.

If you or anyone known to you is accused of ‘Shaken Baby Syndrome’, get a solicitor or lawyer to insist on the immediate release of copies of all medical records relating to the child.

In this particular case the first item of the medical records was accidentally received by the defense 5.5 months after the charges were made, despite repeated request for full records. Some items presented to the court by the prosecution were forgeries.

Author – Brian Williams – Contact e-mail —nets@talktalk.net

Additional Reading.
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