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Child Abuse Case 1

A 10-month-old baby is brought to the ED because of irritability and vomiting. His mother states that he has not been well for the past 5 days. She relates that she fell asleep 5 days ago with the baby on the bed with her and that she awakened after hearing a thump on the floor. The baby cried right away. She brought him to the ED the next day because he vomited once and she became worried. After waiting for 3 hours, she left with the baby without being seen by a physician. The next day, the mom brought the baby to the primary care doctor who reassured her that the baby looked fine. Over the next 2 days he became progressively irritable and then started to vomit repeatedly. In the ED, a CT scan was obtained.

Case 1

Which of the following statements is true?

  1. The CT demonstrates heterogeneity of bilateral subdural hemorrhages.
  2. The CT scan demonstrates a common finding after a short fall.
  3. The CT shows that midline structures are shifted, suggesting increased intracranial pressure.
  4. The CT shows subarachnoid hemorrhage because subdural hemorrhages frequently resorb within 2-3 days after bleeding.

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