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Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 36-40

Imaging evaluation of head injuries in children resulting from negligence

1 Department of Radiology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
2 Department of Forensic Medicine, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
3 Department of Neurosurger, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
4 Department of Emergency, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
5 Vice Deanship of Post-graduate and Research Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia

Correspondence Address:
Khawaja Bilal Waheed
Consultant General Radiologist, King Fahad Military Medical Complex, PO Box - 946, Dhahran 31932
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjfms.sjfms_4_20

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Context: Child abuse comprises physical, sexual, and psychological abuse. Many children evaluated for child abuse have noninflicted injuries due to supervisory neglect. Aims: The aim of this study is to evaluate the imaging findings in children with isolated head injuries due to neglect and to highlight the vulnerable age group. Settings and Design: A retrospective case-based study in Radiology department at King Fahad Military Medical Complex (KFMMC) in the eastern region of Saudi Arabia from January 2017 to 2020. Subjects and Methods: We retrospectively reviewed imaging findings of children (under 18 years) with head injuries related to negligence who were notified under Domestic Violence and Neglect Protection Prevention Program by the Medical Services Department at our KFMMC Hospital in Dhahran. Unconfirmed cases and those who lost follow-up were excluded. Skull radiographs and computed tomography of the brains were evaluated, and findings were labeled as “E” (extracranial, subgaleal hematoma, and scalp injury), “C” (cranial; fracture, and its location), and “I” (intracranial, extradural and subdural hematoma, brain contusion, etc.,). Imaging findings were documented in children aged under 5 years and between 5 and 18 years. Statistical Analysis Used: The Chi-square test was used to determine the association. P < 0.05 was considered statistically significant. Results: Out of total 583 cases of notified child abuse cases, “neglect” accounted for 14.5% (n = 85) of cases, with a mean age of 33 months. Among 85 children with isolated head injuries, abnormal imaging findings were seen in more than half of children (n = 47, 55.2%). Children under 5 years were mostly affected with fractures (C) seen as common findings (n = 34, 72.3%), whereas 19 (40.4%) had intracranial (I) abnormalities (P = 0.89). Conclusions: Head injuries resulting from negligence occur mostly in children under 5 years. Fractures account for more than two-thirds of injuries in children with abnormal imaging findings.

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