title: The "swing-ding": a golf-related head injury in children.
abstract: OBJECTIVE
  In recent years there has been an increased incidence of golf-associated head injuries in children and adolescents. At the authors' institution, they have identified a unique pattern of head injury associated with a swinging golf club. In this study, the authors highlight the mechanism of this injury and report their experience treating it.
  
  
  METHODS
  The authors reviewed the database of Rainbow Babies and Children's Hospital Trauma Center and performed a retrospective analysis of golf injuries recorded over a 10-year period (January 2000-April 2010). They identified 13 children (9 boys and 4 girls) who sustained head injuries in golfing accidents. All patients were 10 years of age or younger. The medical charts were reviewed and follow-up interviews were conducted to better delineate the details of the injuries.
  
  
  RESULTS
  Injuries included 13 depressed skull fractures, 7 epidural hematomas, and 1 cerebral contusion. All 13 patients sustained their injuries after being struck in the head by a golf club. Seven sustained injuries on the follow-through of the initial swing and 3 sustained injuries on the backswing. All but one patient required neurosurgical intervention. Five patients developed neurological sequelae. None of the children had prior experience with golf equipment. All but one injury occurred in the child's own backyard. There was no direct supervision by an adult in any of the cases.
  
  
  CONCLUSIONS
  Golfing can lead to serious head injuries in children. The authors noticed a unique pattern of golf-related head injuries, previously not described, that they have termed the "swing-ding." This golf club-inflicted injury occurs when a child stands too close to a swinging golfer and is struck in the head, subsequently sustaining a comminuted depressed skull fracture in the frontal or temporal region, with or without further intracranial injury. The study suggests that a lack of adult supervision, minimal previous golf experience, and proximity of the child to the swinging golfer are all implicated in this head injury pattern.
authors.affiliation: Division of Pediatric Neurosurgery, University Hospitals Rainbow Babies and Children's Hospital, The Neurological Institute, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Wang
authors.forename: Alan R
authors.initials: AR
authors.lastname: Cohen
authors.forename: Shenandoah
authors.initials: S
authors.lastname: Robinson
mesh_terms: D000059:Accidents; D001930:Brain Injuries / Q000209:etiology; D002648:Child; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006055:Golf / Q000293:injuries*; D006407:Hematoma, Epidural, Cranial / Q000209:etiology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D020204:Skull Fracture, Depressed / Q000209:etiology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed