Forensic evaluation of pediatric head trauma cases admitted to the Akdeni̇z University Hospital between 2018-2022

FORENSIC EVALUATION OF PEDIATRIC HEAD TRAUMA CASES ADMITTED TO THE AKDENİZ UNIVERSITY HOSPITAL BETWEEN 2018-2022 Head traumas are common reasons for emergency visits during childhood. Children are more prone to head traumas due to their larger head-to-body ratio and their heads being closer to their center of mass compared to adults'. We conducted a retrospective analysis of 480 individuals under the age of 18 who were admitted to the Akdeniz University Emergency Department for mechanical head trauma in 5 years period, between January 1, 2018, and December 31, 2022. The data collected in our study were analyzed using the SPSS 22.0 (Statistical Package for Social Science) statistical program. Upon examining the gender and age data of the cases, it was found that 29.0% were female and 71.0% were male, with a median age of 9.5 years. The youngest case was 9 days old, and the oldest was 17 years old. Of all cases, 35.0% presented in 2018, 27.1% in 2019, 11.7% in 2020, 13.5% in 2021, and 12.7% in 2022. When cases were evaluated according to the type of incident, traffic accidents were the most common with 212 (%44.2) cases, followed by falls from height with 104 (%21.7) cases, violence-related traumas with 68 (%14.2) cases including 4 firearm injuries, collisions with objects accidentally with 56 (%11.6) cases, and falls from the same level with 47 (%9.8) cases. Notably, there was statistically significant differences between median ages of cases of traffic accidents and cases of falls from height. Out of the 480 cases, 68 were identified as having a history or suspicion of violence-related trauma based on either historical accounts or findings of physical examination. It was determined that the 15-17 age group had the highest frequency, with 37 (%54.2) cases, whereas the 3-5 age group had the lowest frequency, with 2 (%2.9) cases. The median age of the cases with suspected and reported violence-related trauma was 15,0, whereas it was 9,0 for cases without such history, and this difference was statistically significant. Skull fractures were reported in 26.0% (n=125) cases, and 23.5% cases (n=113) had intracranial injuries. These were identified by radiodiagnostic imaging techniques. In 119 of these cases (detected skull fraktures or intracranial injuries) had findings on physical examination of the head. Skull fractures and intracranial injuries were significantly correlated with physical examination findings of the head. The trauma was life-threatening in 61.5% of fall from height cases, 23.4% of the cases who havefallen from their-level, 42.5% of the traffic accident cases, 11.7% of the violence-related trauma cases, and 12.5% of the cases who have collided with objects. Compared to other types of incidents, falls from height were more likely to result in life-threatening injuries and this differece was statistically significant. Considering both the previously published reports and findings of this study, preventive measures should be implemented to safeguard children from head traumas which have a high frequency and severity in childhood period. Additionally, physicians should meticulously evaluate cases to both fulfill the requirements of the medicolegal procedure and and the well-being of pediatric patients.