Outcome and cost of childhood brain injury following assault by young people.

Introduction: Media interest in inter-juvenile violence in the UK has emphasised to clinicians the lack of data on medical outcomes following injury. A study was undertaken to examine the incidence of childhood head injury in a large trauma centre serving an inner city multiethnic community. The aim was to establish the physical and financial cost of survival with a head injury following inter-juvenile assault.

Methods: All children aged 8-16 years attending King's College Hospital, London (KCH) because of a head injury were identified restrospectively. The case notes of those admitted to the neurosurgical and neurorehabilitation service with a head injury between 1 August 2006 and 30 September 2008 were reviewed.

Results: A total of 1126 children attended KCH with a head injury. Eight boys required admission for treatment of a head injury following alleged inter-juvenile assault. The mechanisms of brain injury included a penetrating knife wound, assault with a bottle and physical assault. One child died following admission as a result of his brain injury. Complete neurological outcome data were available on six cases. Three had a hemiplegia, four had speech and language difficulties, two had visual impairment, five had behavioural changes and five had cognitive difficulties.

Conclusions: This study demonstrates the serious consequences of inter-juvenile assault. Survival can be associated with neurological and psychological deficits. The cost to the health service is substantial. Further work is required to establish the long-term needs of these children.