Which of the following findings in an infant may suggest the presence of subdural hemorrhage indicative of child abuse?

Evaluating physical indicators of non-accidental trauma in infants requires knowledge of intracranial pathophysiology. Identifying clinical markers of increased intracranial pressure and ocular manifestations is vital for detecting severe injuries, such as subdural hematomas, often associated with abusive head trauma. Choice A rationale A normal head circumference, which typically increases by 1 to 2 centimeters per month in early infancy, suggests no acute intracranial swelling. Clear speech is not a relevant assessment for infants who are non-verbal. Choice B rationale Sunken fontanels are a clinical hallmark of dehydration and fluid volume deficit. In contrast, intracranial bleeding or edema would cause the fontanels to feel firm or appear bulging due to increased pressure within the skull. Choice C rationale Flushed cheeks are often associated with fever or environmental warmth. Stable vital signs, including a normal heart rate of 100 to 160 beats per minute, do not typically indicate the presence of an acute hemorrhage. Choice D rationale Bulging fontanels signify increased intracranial pressure from blood accumulation. Retinal hemorrhages are highly specific markers for vitreoretinal traction occurring during violent shaking, commonly seen in subdural hematomas resulting from physical abuse in infants.