When violence strikes the head, neck, and face

The aim of this study was to find characteristics in head-neck-facial (HNF) injuries among victims of violence and to test the hypothesis that the type of injury, location, and mechanism behind it vary between the genders.

A 1-year prospective study including all victims of violence attending the Accident & Emergency (A&E) Department or the Institute of Forensic Medicine in Aarhus was conducted. Every violence-related injury was recorded along with the mechanism behind it, the type of injury, and the specific anatomic location.

A total of 1,106 victims were examined of whom 83% had HNF injuries. Thirty-seven percent had more than one HNF injury. Injuries around the nose and mouth were significantly associated with male victims, whereas injuries to the neck were significantly more common among female victims. Most injuries were the results of assault with a blunt object, where the men much more frequently had open wounds, whereas injuries such as ecchymoses were significantly more frequent among female victims. Use of weapons, such as blunt objects and blows with glass/bottles, was associated much more with male victims, whereas strangulation attempts were significantly more frequent among women. Ten percent of the women had been exposed to strangulation attempts.

The findings support former studies that HNF injuries might be considered as markers of violence. Thus, the staff at A&E Departments must consider anyone with these types of injuries as potential victims of violence. The A&E Department may be the primary entrance for the victims and the main way in which to offer help. The high incidence of women who had been assaulted with strangulation, which is a potentially very dangerous trauma mechanism, intensifies the importance of conducting a careful medical examination, in part, because of the possible legal implications.

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.