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EM@3AM: Pediatric Non-Accidental Trauma

A 3-month-old previously healthy male is brought to the ED by his parents. His father says he rolled off the couch onto a hardwood floor, started crying immediately, and then seemed sleepy and more fussy than usual. On exam, the patient is minimally consolable with a small bruise on his left forehead. Vitals are stable. There are no palpable skull fractures. Due to the age and mechanism, you obtain a head CT which shows a subdural hematoma without midline shift. You obtain a skeletal survey which shows a healing posterior rib fracture. What is the diagnosis?

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