The neurological outcome of non-accidental head injury.
OBJECTIVE
The literature regarding the outcome of non-accidental head injury (NAHI) is scarce and lacks specific detail even though it is generally considered to be poor. The purpose of this study is to review the literature to date and report the neurological outcome of these children in detail.


METHODS
A cross-sectional and prospective study of children admitted to hospital with NAHI in Scotland.


RESULTS
Twenty-five children were enrolled and 68% of children were neurologically abnormal at an average follow-up of 59 months. A wide range of abnormalities and outcomes was seen. Speech and language difficulties were present in 64% including autistic spectrum disorder. Cranial nerve abnormalities were present in 20%. Visual deficits and epilepsy compounded learning difficulties in 25% of survivors. Consent for follow-up was more likely to be obtained where the perpetrator was known.


CONCLUSIONS
The spectrum and degree of severity of neurological abnormalities in survivors of NAHI is extremely variable, with the majority of these children being moderate or severely abnormal. These children require the support of a multi-disciplinary team in the community. Further study regarding the process of follow-up, where complex medicolegal issues exist, are needed in order to facilitate maximum neurological development.
Barlow
Karen
K
University of Calgary, Alberta Children's Hospital, 1820 Richmond Road, Calgary, Alberta, Canada T2T 5C7. karen.barlow@calgaryhealthregion.ca
Thompson
Elaine
E
Johnson
David
D
Minns
Robert A
RA
D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D009460:Neurologic Examination; D011379:Prognosis; D011446:Prospective Studies; D038642:Shaken Baby Syndrome / Q000150:complications* / Q000473:pathology; D013064:Speech Disorders / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology