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Frequency, types and causes of intraventricular haemorrhage in lethal blunt head injuries

H Maxeiner1, Cynthia Schirmer

  • 1Charité - University Medicine of Berlin, Department of Forensic Medicine, Turmstr. 21, D-10559 Berlin, Germany. helmut.maxeiner@charite.de

Legal Medicine (Tokyo, Japan)
|October 16, 2009
PubMed

Insights

Blunt head injuries can cause intraventricular hemorrhage, particularly in severe impacts like traffic accidents. Inner cerebral structure damage, including periventricular injuries, often accompanies these hemorrhages.

Area of Science:

  • Neuropathology
  • Forensic Pathology
  • Trauma Research

Background:

  • Blunt head injuries are a significant cause of mortality.
  • Understanding the patterns of intracranial injury is crucial for forensic classification.
  • Periventricular structures and intraventricular hemorrhages are specific injury types requiring detailed examination.

Purpose of the Study:

  • To analyze autopsy findings of inner cerebral structures and intraventricular hemorrhages in blunt head injury deaths.
  • To correlate the occurrence of these injuries with trauma mechanisms and severity.
  • To investigate the origins and patterns of intraventricular hemorrhages.

Main Methods:

  • Autopsy and neuropathological examination of formalin-fixed brains from 676 blunt head injury cases.
  • Classification of injuries to inner cerebral structures (periventricular, deep white matter, basal ganglia).
  • Analysis of hemorrhage locations and correlation with trauma types and injury patterns.

Main Results:

  • Intraventricular hemorrhage was present in 17.6% of cases (10% distinct/massive).
  • Higher frequency of intraventricular hemorrhage observed in traffic accidents compared to falls.
  • Predominant causes included periventricular injuries (27%) and retrograde expansion of infratentorial lesions (19%).
  • Injuries to inner cerebral structures occurred in 9.1-13.5% (periventricular) and 4.0-5.9% (deep white matter/basal ganglia).

Conclusions:

  • Intraventricular hemorrhage and inner cerebral injuries are typically components of complex, severe blunt head trauma.
  • The severity and type of impact are related to the likelihood of ventricular hemorrhage.
  • Solitary intraventricular hemorrhages or inner cerebral injuries without other clear traumatic findings are rare.

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