Question:
An infant is brought to the casualty with a history of violent shaking by the parents. The most characteristic injury is?
An infant is brought to the casualty with a history of violent shaking by the parents. The most characteristic injury is?
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Shaking tears the bridging veins crossing a particular meningeal space.
Updated On: Jun 24, 2026
- Long bone fracture
- Ruptured spleen
- Subdural hematoma
- Skull bone fracture
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The Correct Option is C
Solution and Explanation
Step 1: The clinical setting is violent shaking of an infant, which describes Shaken Baby Syndrome (abusive head trauma).
Step 2: In shaking, the relatively large heavy head of the infant moves back and forth on weak neck muscles. The acceleration-deceleration and rotational forces tear the delicate bridging veins that cross the subdural space.
Step 3: Tearing of bridging veins produces a subdural hematoma, which is the most characteristic injury of Shaken Baby Syndrome. It is classically associated with retinal hemorrhages and diffuse axonal injury, forming the diagnostic triad.
Step 4: The other options are less specific. Long bone and skull fractures may occur in physical child abuse but usually require direct impact rather than pure shaking, and a ruptured spleen indicates blunt abdominal trauma, not shaking.
Conclusion: The most characteristic injury is subdural hematoma, hence option C.
Step 2: In shaking, the relatively large heavy head of the infant moves back and forth on weak neck muscles. The acceleration-deceleration and rotational forces tear the delicate bridging veins that cross the subdural space.
Step 3: Tearing of bridging veins produces a subdural hematoma, which is the most characteristic injury of Shaken Baby Syndrome. It is classically associated with retinal hemorrhages and diffuse axonal injury, forming the diagnostic triad.
Step 4: The other options are less specific. Long bone and skull fractures may occur in physical child abuse but usually require direct impact rather than pure shaking, and a ruptured spleen indicates blunt abdominal trauma, not shaking.
Conclusion: The most characteristic injury is subdural hematoma, hence option C.
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