A child is brought to the casualty with repos of violent shaking by parents. Most likely injury is?
Long bone fracture
Ruptured spleen
Subdural hematoma
Skull bone fracture
Violent shaking (Shaken Baby Syndrome) is a form of physical child abuse in which the perpetrator holds the child from the thorax and submits him/her to violent acceleration-deceleration forces typically resulting in Non Accidental Head Injury (NAHI) although a number of other injuries may also be noted. Subdural Hemorrhages are the most characteristic findings and are believed to result from shearing of internal vessels by sudden accelerative-decelerative forces during violent shaking. Ref: Traumatic Brain Injury By David X. Cifu, Deborah Caruso, Page 148; The essentials of forensic medicine and toxicology,By K.S Narayan reddy,29th Edition Page 397-99; Manual of Forensic Emergency Medicine by Riviello (2009), Page 139