In suspected Shaken Baby Syndrome, which finding is most commonly associated?

• A. Old fractures on X-ray
• B. Seizure
• C. Bilateral retinal hemorrhage
• D. Blunt head trauma

Answer: (C)

In abusive head trauma, a key clue is involvement of the eyes, with bilateral retinal hemorrhages being most strongly associated. The rapid shaking creates shear forces that tear retinal vessels, often producing hemorrhages in both eyes and across multiple retinal layers. This bilateral pattern is much more characteristic of abusive injury than of typical accidental head trauma, making it the best indicator among the options. Seizures can occur but aren’t as specific, old fractures suggest prior abuse but aren’t as directly linked to the acute presentation, and blunt head trauma can be accidental; the bilateral retinal hemorrhages stand out as the most characteristic finding in this context.