Childhood head injuries: accidental or inflicted?

摘要: OBJECTIVES: To determine the relative incidence of accidental and abusive causes head injuries in children younger than 6.5 years, to identify types craniocerebral damage resulting from reported mechanisms injury, assess likelihood being or inflicted. METHODS: Retrospective review medical records 287 with aged 1 week years admitted a metropolitan children's hospital January 1986 through December 1991. Those patients diagnoses skull fracture; concussion; subarachnoid hemorrhage (SAH); subgaleal, epidural, subdural hematoma (SDH); parenchymal contusion laceration; closed injury were included. Criteria used for inclusion categories definite abuse accident. RESULTS: Accidents accounted 81% cases 19%. The mean age accident group was 2.5 group, 0.7 years. Major differences seen following: SDH, 10% 46% group; SAH, 8% 31% abuse; retinal hemorrhages, 2% 33% group. Associated cutaneous consistent inflicted 16% 50% Twenty-three percent those injured motor vehicle crashes (MVCs), 58% by falls, play activities, rest had insufficient record information. In 56% there no history account MVC. 17%, fall said have been mechanism injury. 24%, admitted. Mortality rates 13% Median stay 9.5 days 3 falls less 4 feet none hemorrhages; among reportedly falling feet, 38% 25% hemorrhages. CONCLUSIONS: A substantial percentage requiring hospitalization are attributable Subdural hematoma, hemorrhage, associated cutaneous, skeletal, visceral significantly more common Language: en