title: Head Trauma-Related Deaths Among Preschool Children in Istanbul, Turkey.
abstract: OBJECTIVE
  Head trauma takes place among the leading causes of mortality in children. This study aimed to determine the risk factors of head trauma-related deaths among children younger than 5 years in Istanbul, Turkey.
  
  
  METHODS
  This study was conducted using the records of the Morgue Department of the Council of Forensic Medicine in Istanbul. The records of cases autopsied between 2008 and 2012 were retrospectively investigated. Of all preschool children deaths, 203 head trauma-related deaths were included in the study.
  
  
  RESULTS
  Of all, 117 (57.6%) were males and 86 (42.4%) were females. Most cases (107, 52.70%) were between the ages of 12 and 36 months. The most common mechanism of injury was "fall from a height" with 97 cases (47.78%), followed by "traffic accidents" (67, 33%) and "hit by falling objects" (19, 9.35%). Skull fracture was detected in 176 cases (86.69%), of which 81 (46.02%) were characterized with linear fracture. Furthermore, skull fracture was accompanied by 1 or more skeletal bone fracture in 64 cases. Retinal hemorrhage was investigated in 5 cases of suspected physical abuse and only 2 of them showed retinal hemorrhage findings.
  
  
  CONCLUSIONS
  Obtained findings revealed that fall from a height was the leading cause of death among unnatural deaths in children younger than 5 years. Domestic accident was found to be a significant risk factor in childhood deaths. Traffic fatalities were among leading causes of death in childhood in our country, likewise in all around the world. Children were found to be more vulnerable to traumas when they start to move around with incomplete motor skills. Therefore, education of parents in terms of child supervision and installing safety precautions toward preschool children will be helpful in preventing such injuries. On the contrary to some findings in the literature, more severe lesions were also prominent even in case of short-range falls from a height.
authors.affiliation: From the *Istanbul Medeniyet University Medical Faculty, Istanbul; †Council of Forensic Medicine, Istanbul; and ‡Pamukkale University Medical Faculty, Denizli, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yagmur
authors.forename: Safa
authors.initials: S
authors.lastname: Celik
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yener
authors.forename: Fatma
authors.initials: F
authors.lastname: Koral
authors.forename: Tuba
authors.initials: T
authors.lastname: Yaman
authors.forename: Yigit
authors.initials: Y
authors.lastname: Sezer
authors.forename: Eyup
authors.initials: E
authors.lastname: Kandemir
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000063:Accidents, Traffic / Q000401:mortality*; D001344:Autopsy / Q000706:statistics & numerical data; D002649:Child Abuse / Q000401:mortality; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000401:mortality*; D003937:Diagnosis, Differential; D005260:Female; D050723:Fractures, Bone / Q000401:mortality; D016489:Head Injuries, Closed / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000401:mortality; D014421:Turkey / Q000453:epidemiology