STEP 2: Concussion Live Course - October 21-22, 2025, in Salt Lake City, UT-Case Discussion: Risk Factors of Special Populations (Intimate Partner Violence)

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This case involves a 39-year-old Hispanic woman with a history of intimate partner violence (IPV) resulting in multiple head injuries and concussion-related symptoms. She has experienced a history of abuse over several years, including falls, syncope episodes, physical assaults, strangulation attempts, and knee injuries caused by her partner and ex-partner. Despite prior medical visits and diagnoses of concussion and cognitive impairment due to repeated head trauma, her abuse continues, compounded by stalking and ineffective police interventions. She has three children, two of whom live with relatives due to safety concerns.<br /><br />IPV is a significant public health issue, affecting 1 in 4 women and 1 in 9 men, commonly involving physical violence, sexual violence, and stalking. IPV constitutes 15% of all violent crimes, predominantly impacting women aged 18-24. Notably, only about one-third of victims seek medical care, and up to 60% may lose employment as a consequence of abuse-related trauma. Injuries frequently affect the head, face, and neck, with up to 92% involving such sites. These assaults commonly cause brain injuries, including traumatic brain injury (TBI) or concussion.<br /><br />This patient’s symptoms include frequent debilitating headaches, cognitive deficits such as delayed processing and poor recall, depression, anxiety, insomnia, hearing loss, blurred vision, and impaired balance. Physical exam revealed difficulties in gait and neurological testing consistent with neurocognitive impairment. There is currently no validated screening tool specific for IPV-related brain injury.<br /><br />Risk factors for IPV-related brain injury include pre-existing mental health disorders, sociodemographic factors, prior head trauma, social stigma, gender inequality, and repetitive trauma over time. This case underscores the complexity and severity of IPV-induced brain injuries and the urgent need for heightened clinical awareness, comprehensive care, and effective interventions to protect and support survivors.

Asset Subtitle

Kathleen R. Bell, MD

Keywords

intimate partner violence

IPV

head injuries

concussion

brain injury

traumatic brain injury

Hispanic woman

cognitive impairment

domestic abuse

neurocognitive deficits