Clinico-Epidemiological Study of Fatal Head Injuries in an Autopsy

Abstract

Introduction: Head injury is a significant public health problem worldwide. Traumatic head injury is a leading cause of death and disability in children and adults in their most productive years. The morbidity and mortality due to head injury is on the rise and is one of the prime importance in today’s medical practice. Objective: To assess the clinico-epidemiological study of fatal head injuries in an autopsy. Methods: The present study was conducted of the Department of Forensic Medicine & Toxicology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January to June 2022. Total 250 patients included in this present study. We selected only fatal head injury cases due to mechanical violence. However, we included severe facial injury cases too as these cases were associated with head injury. But, the present study doesn’t involve crushed head injury or survived cases, referred or LAMA cases brought in the hospital. Results: Maximum cases were seen in the age range of 21-30yrs, 57 cases (22.8%). Maximum cases were seen amongst males, 196 cases, 78.4%. The commonest causes of fatal head injuries are Road Traffic Accident (RTA) cases. Other important causes of fatal head injuries are fall from height, assault & railway accidents. External head injuries were mainly seen on frontal and parietal regions. Amongst the scalp injuries lacerations were very common seen in 114 cases, 36.19%. Skull bone fractures were frequently seen in fatal head injury cases. Presence of skull bone fractures are associated more frequently with fatal complications. Though linear fractures are common in general we observed the comminuted fractures as the commonest type of skull fractures in fatal head injury cases, seen in 73 cases, (58.4%). Depressed fractures were less common in fatal cases. Involvement of cranial fssa was seen in 108 cases. Linear type of fractures both transverse and horizontal type was more common seen in 66 coases amongst the 108 cases of cranial fossa involvement i.e. 61.11%. Involvement of middle cranial fossa was high seen in 45 cases of the 108 cases i.e. (41.66%). Presence of comminuted skull bone fractures is associated with higher rate of mortality. Conclusion: Most of the cases were due to road traffic c accidents and males are more prone to get Head injury. Other important causes of fatal head injuries are fall from height, railway accidents and assaults in descending order. To reduce the morbidity and mortality it’s high time for the concerned authority to take appropriate actions.