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April 22, 1968

Subgaleal Hematoma Caused by Hair-Pull

Author Affiliations

Boston and Providence, RI

JAMA. 1968;204(4):339. doi:10.1001/jama.1968.03140170055017

To the Editor:—  The most likely cause of childhood subgaleal hematoma is a vigorous hair-pull by the grip of an enraged adult, a clue to "the battered-child syndrome."The "battered" or "maltreatment" syndrome of childhood has to be seen to be believed. Many children become the pitiable recipients of adult rage, but one is seldom brought to the physician or the hospital emergency department. The diagnosis is usually missed or overlooked or, if suspected, not reported for lack of evidence. A vast majority of beaten children—many with grievous injuries—are somehow nursed to recovery (between assaults) by the perpetrators who most likely are the parents—real or foster, remorseful or not—or by anonymous samaritans. Furor gives way to fear, then panic, when the attacker or a surrogate realizes that the victim has been seriously hurt and might not survive. The falsified history is abetted by a conspiracy of familial deceit, and a

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