NCJ Number
206593
Journal
Child Abuse Review Volume: 13 Issue: 3 Dated: May-June 2004 Pages: 178-187
Date Published
May 2004
Length
10 pages
Annotation
This article describes the physical and educational outcomes for children less than 2 years old who were diagnosed with a subdural hemorrhage caused by physical abuse; guidelines for follow-up are proposed.
Abstract
A total of 65 children admitted to hospitals in South Wales and southwest England between 1992 and 1998 met the aforementioned criteria. In all cases, a subdural hemorrhage was diagnosed through neuroimaging or at postmortem. The Kings Outcome Scale for Childhood Head Injury (KOSCHI) was used. Sixteen of the children died (13 within 3 weeks and 3 children 5 years after the injury). Of the 45 children followed up within 22 to 103 months, 25 had a good outcome; 6 were moderately disabled; 11 were severely disabled; and 3 were in a persistent vegetative state. The problems identified at follow-up included cerebral palsy (n=16), ongoing seizures (n=5), visual problems (n=11), speech and language problems (n=17), and behavioral problems (n=13). Of the 29 children of school age for whom educational data were available, 12 had received a statement of educational need. Given the high proportion of children who had significant physical, cognitive, and behavioral problems related to a subdural hemorrhage, regular follow-up by a multidisciplinary team may facilitate early identification of emerging problems and optimize their treatment. Such a team should include a community pediatrician, therapists, school health personnel, and ophthalmologists. A prospective study should be conducted to identify any subtle problems that may emerge over time with children who may appear to have a good outcome. 3 tables and 16 references