NCJ Number
168490
Journal
Child Abuse and Neglect Volume: 21 Issue: 10 Dated: (October 1997) Pages: 929-940
Date Published
1997
Length
12 pages
Annotation
The medical charts of 95 children who died as a result of accidental head injuries were studied to determine the normal clinical progression of fatal head injuries in children and to aid in the determination of the time of injury in investigations of nonaccidental trauma.
Abstract
Data came from the trauma database at the Children's Hospital and Health Center in San Diego, Calif. The participants were 16 years of age and younger and had suffered fatal accidental injuries involving blunt head injuries from August 1984 to July 1995. All the cases involved either a Glasgow Coma Scale of 14-15 or were described as having a lucid interval or being conscious. The times of events recorded in the medical charts were used to determine the survival time after injury. Results revealed that one case with a lucid interval also involved an epidural hematoma. Results also revealed that brain swelling indicated on head CTs could be detected as early as 1 hour and 17 minutes after the injury. Findings indicated that the children studied were in obvious serious medical condition from the time of injury until death. Findings suggested that children who die of blunt head injuries probably do not experience lucid intervals. The time of most fatal head injury events can be restricted to the time period after the last confirmed period of wellness for the child. In addition, the presence of brain swelling on a head CT scan is not helpful in restricting the time of injury. Tables, figures, and 9 references (Author abstract modified)