The classic triad of shaken baby syndrome (abusive head trauma) consists of:

• A Cerebral contusion, subdural haematoma, skull fracture
• B Epidural haematoma, retinal haemorrhages, contrecoup cortical contusion
• C Coup contusion, subarachnoid haemorrhage, orbital floor fracture
• D Subdural haematoma, retinal haemorrhages, diffuse axonal injury (encephalopathy) without external head impact marks ✓

Explanation

Shaken baby syndrome (now termed abusive head trauma) is characterised by the triad of subdural haematoma (from bridging vein tearing due to acceleration-deceleration), diffuse retinal haemorrhages (from vitreoretinal traction during shaking), and diffuse axonal injury/encephalopathy, typically WITHOUT external signs of impact on the scalp. Epidural haematoma is typically due to direct impact and arterial rupture; coup-contrecoup and orbital fractures are not part of the classic shaking triad.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.