A Retrospective Epidemiological Analysis of Non-Accidental Head Injury in Children in Scotland over a 15 Year Period

Abstract

A retrospective analysis of the epidemiological characteristics of non-accidental head injury (NAHI) in children in Scotland over the last fifteen years from 1981 until March 1996 was performed. The information was provided by the Information and Statistics Division of the Scottish Health Service. The average incidence of NAHI calculated over this period was 0.04 cases per year per 1000 children under 5 years. Fifty-five per cent of all cases occurred in those children who were less than a year old. 41% of cases were inflicted by a parent but in 47% the perpetrator could not be identified. The mortality rate was found to be 2%.

Non-accidental head injury cases identified using the ICD-9 coding classification system gives a surprisingly low incidence. This number is probably an underestimate and the reasons for this are discussed. A prospective epidemiological analysis of NAHI in children in Scotland is being undertaken to determine the true incidence.

Keywords

Non-accidental head injury children incidence epidemiology Scotland

Get full access to this article

View all access options for this article.

References

Caffey

: On the Theory and Practice of Shaking Infants. Amer J Dis Child, 1972; 124, 161–169.

Kempe

Silverman

Steele

: The battered-child syndrome. JAMA 1962; 181, 17–24.

Baldwin

Oliver

: Epidemiology and Family Characteristics of severely abused children. Brit. J prev. soc. Med. 1975; 29: 205–221.

Goldstein

Kelly

Bruton

Cox

: Inflicted versus accidental head injury in critically injured children. Crit Care Med. 1993; 21: 1328–1332.

Hargrave

D R

Warner

D P

. A study of child homicide over two decades. Med, Science & the Law., 1992; 32, 247–250.

Brown

J K

Minns

R A

. Non Accidental Head Injury, with particular reference to whiplash shaking injury and medico-legal aspects. Dev. Med. Child Neurol., 1993:35: 849–869.

Duhaime

Gennarelli

Thibault

. The Shaken Baby Syndrome. J. Neurosurg., 1987; 66, 409–415.

de Silva

Oates

. Child homicide — The extreme of child abuse. Med J Aust., 1993; 158, 300–301.

Smith

Hanson

. 134 Battered children: A medical and psychological study. Br Med J, 1974; 3, 666–670.

10.

Ryan

Davis

Oates

. One hundred and eighty seven cases of child abuse and neglect. Med J Aust., 1977; 2, 623–628.

11.

Bonnier

Nassogne

Evrard

. Outcome and prognosis of whiplash shaken infant syndrome; late consequences after a symptom-free interval. 1995; 37, 943–95.