A child brought to casualty with reports of violent shaking by parents. The most likely injury is?
Long bone fracture
Ruptured spleen
Subdural haematoma
Skull bone fracture
Violent shaking (by parent) may cause subdural hematoma; whereas ruptured spleen occurs due to compression of abdomen; long bone fracture due to compression, bending, direct blow, pulling and twisting; and skull fractures due to direct blow.
Caffey (1974) described the effects of shaking as a major cause of subdural haematoma and intraocular bleeding in battered babies or infantile whiplash syndrome.