Child brought to casualty with repos of violent shaking by parents. Most likely injury is?
Ref: the essentials of forensic medicine and toxicology-Dr.K.S.Narayana Reddy 32nd edition pg no:247-248 SUBDURAL HAEMORRHAGE: causes : it is more commoner than extra dural haemorrhage . it is common in childhood or old age. this is occur between the duramater and arachnoid mater due to 1) rupture of parasagital bridging or communicating veins near saggital sinus. 2)rupture of inferior cerebral vein 3)rupture of dural venous sinuses 4)injury to coical veins subdural haemorrhage may occur from relatively slight trauma often insufficient to cause uncounsiousness and usually not producing fractures of the skull.death may ocuur if the haemorrhage is about 100 to 150 ml. rapid development of the subdural haematoma will cause compression of the brain stem and secondary brain damage.fatal subdural haemorrhages are usually associated withn contusions or lacerations of the brain and fracture of skull.often the accumulate gradually with slow bleeding a considerably large haematoma can be tolerated without symptoms or serious isde effects. typers : it is divided into 3 according to the time of onset of symptoms 1)acute haemorrhage occurs immediately and very rapidly after trauma 2)subacute type, the symptoms develop from 2 to 3 days after injury due to pessure of haematoma.the clot contain some dark fluid with formation of a thin peripheral membrane 3) chronic type results from slight trauma in which symptoms appear some weeks or some months later.
Long bone fracture
Ruptured spleen
Subdural haematoma
Skull bone fracture
Miscellaneous