A postmortem examination of a 4-month-old infant shows bilateral retinal haemorrhages, subdural haematoma, and rib fractures at different stages of healing with no external evidence of impact. No ligature marks or external neck injuries are found. The cause of death is most likely:
- A Traumatic asphyxia
- B Smothering with a soft object
- C Shaken baby syndrome (non-accidental head injury) ✓
- D Overlaying (postural asphyxia)
Explanation
The classic triad of shaken baby syndrome (SBS) consists of subdural haematoma, diffuse axonal injury/cerebral oedema, and bilateral retinal haemorrhages (highly specific for acceleration-deceleration injury), occurring in the absence of external trauma. Healing rib fractures at different stages indicate repeated abuse. Smothering leaves no internal cranial findings in isolation. Overlaying occurs during sleep and produces asphyxial signs without subdural haematoma. Traumatic asphyxia requires severe external chest compression producing the classical congested cyanotic face.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.