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Non-accidental head injury — MRCPCH FOP MCQ

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HardEmergency paediatricsNon-accidental head injuryMRCPCH FOP

A 5-month-old boy is brought after a reported short fall from a sofa. He is drowsy, has a bulging fontanelle, retinal haemorrhages and CT head shows subdural bleeding of different ages. What is the most likely diagnosis?

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Correct answer: C — Abusive head trauma

Subdural bleeding of different ages, retinal haemorrhages and an inconsistent low-energy mechanism are highly concerning for abusive head trauma. A simple fall from a sofa would not usually explain this constellation. Viral encephalitis may cause reduced consciousness but not the injury pattern. The pearl is to prioritise medical stabilisation and safeguarding processes in parallel.

Reference: NICE CG89 Child maltreatment; RCPCH Child Protection Companion