What is the most common sign of child abuse in the head region?

Retinal hemorrhages are recognized as a significant indicator of child abuse, particularly in cases involving head trauma. When an infant or young child presents with retinal hemorrhages, it raises concern for non-accidental injury, especially if there is a concurrent history suggestive of trauma or underlying health issues. These hemorrhages can occur due to violent shaking or blunt force trauma, leading to forces that cause bleeding in the retinal vessels.

In young children, the presence of retinal hemorrhages is often seen in cases of abusive head trauma, also known as shaken baby syndrome. This condition involves traumatic accelerative-decelerative forces, leading to a combination of brain injury, subdural hematomas, and retinal hemorrhages. Other signs of abuse may include varying patterns of bruising or fractures, but retinal hemorrhages are particularly notable for their association with abusive situations.

The other options like facial injuries, fractured skull, and bruising above the eyes can occur in both abusive and non-abusive contexts, making them less specific indicators of child abuse compared to retinal hemorrhages.