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Outcome and cost of childhood brain injury following assault by young people
  1. Claire T Lundy1,
  2. Claire Woodthorpe1,
  3. Tammy J Hedderly1,
  4. Chris Chandler1,
  5. Tunji Lasoye2,
  6. David McCormick1
  1. 1Department of Paediatric Neurosciences, King's College Hospital NHS Foundation Trust, London, UK
  2. 2Department of Emergency Medicine, King's College Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Claire T Lundy, Department of Paediatric Neurosciences, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; claire.lundy{at}kch.nhs.uk

Abstract

Introduction Media interest in inter-juvenile violence in the UK has emphasised to clinicians the lack of data on medical outcomes following injury. A study was undertaken to examine the incidence of childhood head injury in a large trauma centre serving an inner city multiethnic community. The aim was to establish the physical and financial cost of survival with a head injury following inter-juvenile assault.

Methods All children aged 8–16 years attending King's College Hospital, London (KCH) because of a head injury were identified restrospectively. The case notes of those admitted to the neurosurgical and neurorehabilitation service with a head injury between 1 August 2006 and 30 September 2008 were reviewed.

Results A total of 1126 children attended KCH with a head injury. Eight boys required admission for treatment of a head injury following alleged inter-juvenile assault. The mechanisms of brain injury included a penetrating knife wound, assault with a bottle and physical assault. One child died following admission as a result of his brain injury. Complete neurological outcome data were available on six cases. Three had a hemiplegia, four had speech and language difficulties, two had visual impairment, five had behavioural changes and five had cognitive difficulties.

Conclusions This study demonstrates the serious consequences of inter-juvenile assault. Survival can be associated with neurological and psychological deficits. The cost to the health service is substantial. Further work is required to establish the long-term needs of these children.

  • Paediatric injury
  • clinical assessment
  • neurology
  • violence
  • paediatrics

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The local research ethics Chair considered that, as the cohort was retrospective and anonymised, it did not require full ethical review under the terms of the Governance Arrangements of Research Ethics Committees in the United Kingdom.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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