When Violence Strikes The Head, Neck, and Face

Brink, Ole

doi:10.1097/ta.0b013e318182f77f

Cited by 49 publications

(68 citation statements)

References 19 publications

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“…The significance of facial injuries in assault is well-established in younger assault victims, with 62%-83% of victims presenting to the Emergency Department having facial injuries. 34, 35, 42 The face is a common site of injury, likely because it is exposed and vulnerable to an assailant. 33, 34, 43 In addition, when desiring to incapacitate, badly hurt, or humiliate a victim, the head and face are attractive targets.…”

Section: Discussionmentioning

confidence: 99%

“…33, 34, 43 In addition, when desiring to incapacitate, badly hurt, or humiliate a victim, the head and face are attractive targets. 33, 43 Researchers have suggested that these injuries may be used to identify victims of violence or raise suspicion of violence-related injury 42, 44–47 and have even begun to identify patterns among maxillofacial injuries that may be suggestive of assault rather than accident. 48 In a multi-center study, most common facial fractures after assault were of the mandible, zygoma, and orbit, with these prominent areas more likely injured given that a fist to the face is the most common mechanism of injury.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Rosen

Clark

Bloemen

et al. 2016

Injury

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Introduction While geriatric trauma patients have begun to receive increased attention, little research has investigated assault-related injuries among older adults. Our goal was to describe characteristics, treatment, and outcomes of geriatric assault victims and compare them to geriatric victims of and younger accidental injury assault victims. Patients and Methods We conducted a retrospective analysis of the 2008–2012 National Trauma Data Bank. We identified cases of assault-related injury admitted to trauma centers in patients aged ≥60 using the variable “intent of injury.” Results 3,564 victims of assault-related injury in patients aged ≥60 were identified and compared to 200,194 geriatric accident victims and 94,511 assault victims aged 18–59. Geriatric assault victims were more likely than geriatric accidental injury victims to be male (81% vs. 47%) and were younger than accidental injury victims (67±7 vs. 74±9 years). More geriatric assault victims tested positive for alcohol or drugs than geriatric accident victims (30% vs. 9%). Injuries for geriatric assault victims were more commonly on the face (30%) and head (27%) than for either comparison group. Traumatic brain injury (34%) and penetrating injury (32%) occurred commonly. The median injury severity score (ISS) for geriatric assault victims was 9, with 34% having severe trauma (ISS≥16). Median length of stay was 3 days, 39% required ICU care, and in-hospital mortality was 8%. Injury severity was greater in geriatric than younger adult assault victims, and, even when controlling for injury severity, in-hospital mortality, length of hospitalization, and need for ICU-level care were significantly higher in older adults. Conclusions Geriatric assault victims have characteristics and injury patterns that differ significantly from geriatric accidental injury victims. These victims also have more severe injuries, higher mortality, and poorer outcomes than younger victims. Additional research is necessary to improve identification of these victims and inform treatment strategies for this unique population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Rosen

Clark

Bloemen

et al. 2016

Injury

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“…At present, the clustering of head, face and neck injuries in young adult women appears to reflect physical violence between partners who are in IT or MVC relationships (Muelleman et al ., ; Novak, ; Johnson, ; Lau et al ., ; Brink, ) but not exclusively so, and this result raises issues for how middle‐aged and older people, both past and present, are recognised as victims of DV rather than assault or elder abuse. These problems are recognised more widely, as there are a growing number of dissenting voices in the clinical, forensic and social science literature who are concerned about the overreliance on models and ‘check‐lists’ of injury patterning (Engle Merry, ; Juarez & Hughes, ; Katerndahl et al ., ; Reijnders & Ceelen, ).…”

Section: Discussionmentioning

confidence: 99%

Identifying and Interpreting Domestic Violence in Archaeological Human Remains: A Critical Review of the Evidence

Redfern

2015

Intl J of Osteoarchaeology

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This research reviews and discusses the clinical and social science datasets used to identify victims of domestic violence (DV) in the archaeological record. Clinical sources are skewed by law enforcement and cost issues, dominated by Western female data and suggest that DV is a well-documented form of abuse. Social science sources and perspectives, having arisen from activist movements, are more spatiotemporally diverse in breadth and perspective, and challenge the notion that DV is universal and well-documented, but are biased because they rely upon self-survey reports. Palaeopathology and bioarchaeology have adopted a clinical approach to DV, relying on a pattern of injuries (focussed on the head, face and neck), without critically evaluating whether such datasets are appropriate to the spatiotemporal and socio-cultural diversity present in the archaeological record. A case study evaluating the injury patterns in 964 post-medieval adult females from London (England) demonstrates that the majority of injuries that conform to the clinical model have robust alternative explanations, and only a small minority of females have injuries that may have been produced by interpersonal violence, not necessarily DV.In conclusion, the review highlights that the perspectives of the elderly and male victims are currently neglected in research, and evidence for injury, especially that which may reflect abuse, necessitates interpretation within a 'web of violence' approach, as DV does not occur in isolation from other violence in a community. It challenges the 'check-list' approach to interpretation and suggests that a closer examination of fracture mechanism combined with injury patterning may be a more informative approach with which to identify DV victims of both sexes and identifies the need to integrate other health data into the interpretation of violence and abuse. Overall, it concurs with the minority of clinical and forensic literature that it might not be possible to differentiate DV and assault victims.

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“…Child abuse is especially problematic as most children survive abusive injuries or the ensuing death is not detectible from the skeletal remains, although cases for abuse have been proposed by Blondiaux et al (2002) in France and by Wheeler et al (2007) in Egypt. If we look to clinical research for guidance, clinicians have been unsuccessful in their quest for skeletal abuse indicators among adults, although soft tissue facial injuries are profuse (Allen et al 2007;Brink 2009). We tend to assume that domestic violence was perpetrated by males, when in fact cultural anthropologists observe that active female participation is widespread particularly in same-sex relationships (McClennen 2005) or in polygynous societies, where altercations among co-wives are regarded as unimportant "nonevents" (Burbank 1994).…”

Section: Social and Cultural Meaningmentioning

confidence: 99%

Trauma

Judd

Redfern

2011

A Companion to Paleopathology

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When Violence Strikes The Head, Neck, and Face

Abstract: HNF injuries are characteristic among victims of violence, although significant differences exist in the type of injuries, the location, and the trauma mechanism between men and women.

Cited by 49 publications

References 19 publications

Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Identifying and Interpreting Domestic Violence in Archaeological Human Remains: A Critical Review of the Evidence

Trauma

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