Outcome and cost of childhood brain injury following assault by young people.
BACKGROUND
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.
Lundy
Claire T
CT
Department of Paediatric Neurosciences, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK. claire.lundy@kch.nhs.uk
Woodthorpe
Claire
C
Hedderly
Tammy J
TJ
Chandler
Chris
C
Lasoye
Tunji
T
McCormick
David
D
D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D002391:Catchment Area, Health; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005190:Family; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008131:London; D008297:Male; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D014754:Violence