Background: Abusive head trauma is one of the major causes of severe head injury in infants and is associated with significant morbidity and mortality. Shaking impact is the most common mechanism of trauma. Early recognition is crucial for timely intervention and prevention of further injury.

Cases: We present two cases of children with abusive head trauma. An abandoned 3-year-old female child presented with severe dehydration and emaciation.  On examination, she had hypertonia of all limbs, with delayed developmental milestones. A clinical diagnosis of dyskinetic cerebral palsy was considered. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed bilateral chronic gross subdural hemorrhages causing severe compression of cerebral parenchyma. Old hemorrhagic contusions with gliotic changes were noted in frontoparietal and temporal regions. A linear fracture was identified in right parietal bone extending into squamous part of right temporal bone.

2-month-old female child presented with an episode of seizures, with no history of trauma. CT of the brain demonstrated acute-on-subacute right subdural hemorrhage with a midline shift of 5.8 mm, along with few contusions in right parietal lobe.

Conclusion: These findings highlight that subdural hemorrhage, particularly in the absence of a relevant trauma history, is a strong indicator of abusive head trauma. This case series highlights the characteristic CT and MRI findings of abusive head trauma and highlights the crucial role of radiologists in recognizing imaging patterns suggestive of non-accidental injury, particularly when clinical history is absent or inconsistent.