Violent head trauma in China: report of 2254 cases.
BACKGROUND
The occurrence of violent trauma has recently increased, and it has become both a social and medical problem in China. We are the first to explore violent head trauma in China.


METHODS
Patients with violent head trauma were taken from all hospitalized patients with head trauma from January 2001 to December 2006 admitted to 11 hospitals in China. The rate, causes, age, sex, injury severity (GCS score), CT findings, management, outcome, and complications of patients with violent head trauma were retrospectively analyzed.


RESULTS
Two thousand two hundred fifty-four (9.46%) patients with violent head trauma were found among a total of 23816 hospitalized patients with head trauma at 11 hospitals. Violent head trauma was caused by blunt objects (n = 1260, 55.90%), sharp/cutting instruments (n = 271, 12.02%), gunshots (n = 10, 0.44%), and others (n = 713, 31.63%). Violent head trauma was more likely to be found men (n = 1890, 83.85%) and in persons aged 21 to 40 years (n = 1216, 53.95%). In 2254 patients with violent head trauma, scalpel injury was seen in 1277 cases, skull fracture in 786 cases, cerebral contusion in 285 cases, and intracranial hematomas in 898 cases. Five hundred eighty-nine (26.13%) patients had body violent trauma besides violent head trauma. A GCS score of 13 to 15 was found in 1869 (82.92%) patients, 9 to 12 in 166 (7.36%), and 8 or less in 219 (9.72%). One thousand forty-two patients got surgical treatment, and another 1212 received medical management. One thousand nine hundred thirty-one (85.67%) patients had good recovery, 141 (6.47%) had moderate deficits, 36 (1.65%) had severe deficits, 7 (0.32%) had PVS, 63 (2.89%) died, and for the other 76, records were lost.


CONCLUSIONS
Violent head trauma is certainly both a social and medical problem now, which indicates that violence should be controlled and that the human right of social safety needs to be improved in China.
Department of Neurosurgery, Renji Hosptial, Shanghai Jiaotong University/School of Medicine, Shanghai 200127, People's Republic of China. jiangjyb@online.sh.cn
Ji-Yao
JY
Jiang
Hua
H
Feng
Zheng
Z
Fu
Gao
G
Guo-yi
Li
L
Wei-ping
Liu
L
Wei-guo
Long
L
Lian-shen
Lu
L
Xiao-jie
Qian
Q
Suo-kai
Xu
X
Wei
Yang
Y
Xiao-feng
Yu
Y
Rui-tong
Zhang
Z
Sai
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011859:Radiography; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014754:Violence