Current patterns of inflicted head injury in children

The purpose of this study was to examine the current patterns of head traum a associated with child abuse. We reviewed the records of all patients admi tted to our medical center between 1995 and 1997 with a primary diagnosis o f head trauma, and analyzed the clinical presentation, mechanism of injury, socioeconomic status and outcome for these patients. Head trauma was delib erately inflicted in 38/405 children (9%). There were 25 boys and 13 girls, with a median age of 5.5 months. Two thirds of the families lived in the i nner city. Of the 99 children under the age of 2 years admitted for head tr auma, the injury was inflicted in 32 (32%), Acute subdural hematoma was pre sent in 22/32 (69%) of children with inflicted trauma, but in only 5/68 (7% ) with accidental trauma. Retinal hemorrhages were present in 17/32 (53%) a bused children, but in no cases of accidental trauma (0/68). Deliberately i nflicted injury is a frequent cause of serious head trauma in young childre n. Head injury is a major cause of morbidity and mortality in the abused ch ild. Child abuse cases correlated strongly with low socioeconomic status. N onaccidental trauma must be considered strongly in children under 2 years o f age who present with acute subdural hematoma in the absence of a history of a motor vehicle accident. Copyright (C) 2000 S. Karger AG, Basel.