Yagmur Fatih, Celik Safa, Yener Zeynep, Koral Fatma, Yaman Tuba, Sezer Yigit, Kandemir Eyup
From the *Istanbul Medeniyet University Medical Faculty, Istanbul; †Council of Forensic Medicine, Istanbul; and ‡Pamukkale University Medical Faculty, Denizli, Turkey.
Am J Forensic Med Pathol. 2016 Mar;37(1):35-9. doi: 10.1097/PAF.0000000000000213.
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.
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.
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.
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.
头部创伤是儿童死亡的主要原因之一。本研究旨在确定土耳其伊斯坦布尔5岁以下儿童头部创伤相关死亡的危险因素。
本研究使用伊斯坦布尔法医委员会停尸房部门的记录。对2008年至2012年间尸检病例的记录进行回顾性调查。在所有学龄前儿童死亡病例中,203例头部创伤相关死亡病例纳入本研究。
其中,男性117例(57.6%),女性86例(42.4%)。大多数病例(107例,52.70%)年龄在12至36个月之间。最常见的受伤机制是“高处坠落”,共97例(47.78%),其次是“交通事故”(67例,33%)和“物体砸伤”(19例,9.35%)。176例(86.69%)检测到颅骨骨折,其中81例(46.02%)为线性骨折。此外,64例颅骨骨折伴有1处或多处骨骼骨折。对5例疑似身体虐待病例进行了视网膜出血调查,其中仅2例有视网膜出血表现。
研究结果显示,高处坠落是5岁以下儿童非自然死亡的主要原因。家庭意外被发现是儿童死亡的一个重要危险因素。交通事故是我国儿童死亡的主要原因之一,在全世界也是如此。发现儿童在运动技能尚未完全发育时更容易受到创伤。因此,对家长进行儿童监管教育并对学龄前儿童采取安全预防措施将有助于预防此类伤害。与文献中的一些研究结果相反,即使是短距离的高处坠落,也会出现更严重的损伤。