ABSTRACT
The characteristic history for non-accidental injury is a trivial trauma or no trauma at all, with the baby presenting as being lethargic and vomiting. The finding of bilateral retinal bleeds is pathognomonic of non-accidental injury. Scalp swelling that is restricted by the sutures and does not cross the suture lines is a cephalhaematoma and is commonly seen in neonates following parturition. In a five-year-old child who is complaining of headache and vomiting following a head injury one should rule out a mass lesion and the best investigation is a Computed tomography (CT) scan of the head which will identify an intracranial bleed or contusion. If a child is drowsy, persistently vomiting, complaining of headache, has evidence of cerebrospinal fluid leak or has localising signs, they should be sent for a CT scan of the brain. Bulbar–cervical dissociation results from spinal cord injury at or above C3 level and produces immediate pulmonary and often cardiac arrest.
