Head injury in victims of child abuse and neglect : 5-year experiences in a medical center

Background： The numbers of victims of child abuse and neglect keep on rising in recent decades. Head injuries resulting from abuse or neglect often lead to long-term neurological sequels or morbidity. The aim of the study... [ view full abstract ]

Background： The numbers of victims of child abuse and neglect keep on rising in recent decades. Head injuries resulting from abuse or neglect often lead to long-term neurological sequels or morbidity. The aim of the study was to clarify the risk factors, mechanism of injuries and outcomes in abused child suffering head injury.
Methods：During the 2009-2014, we retrospectively reviewed the medical reports of abused child in Kaohsiung medical university hospital. Clinical characteristics including age, gender, underlying diseases, familial and social risk factors, mechanisms and site of injury, location of crime, perpetrators, mortality rates and outcomes were analyzed.
Results： 1024 patients (mean age = 11.1 +/- 5.7 y) were identified as victims of child abuse and neglect. 250 patients (25%) suffering head injury was recorded. 55 patients (21%) was lived in a single parent family. 11 patients (6%) was dropped off from school. The most common locations of crime are located at home (64%) and school (37%). Classmates (38%) and father (18%) are the perpetrators with highest incidence and 15% of them were suffered from the abused events for more than once. 8% of the patients (mean age = 4.67 +/- 2.03 y) with head injury required ICU care. Totally, nearly 5% of the abused child (mean age = 1.53 +/- 1.99 y) with head injury expired after the events.
Conclusions： Head injury is one of the most common form of child abuse and neglect. Patients during toddler and infancy had higher risks to have serious head injury. Adequate social support within family and safe work in school may reduce the number of victims. The results of our study present the features of head injury resulting from abuse and neglect and emphasized the role of pediatric neurologists in identifying and caring the abused child.