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Clinical Profile and Autopsy Findings in Fatal Head Injuries.

R Joseph Alexis1, S Jagdish1, Sanjay Sukumar2

  • 1Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry, India.

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|November 16, 2018
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Summary
This summary is machine-generated.

Fatal head injuries are often caused by road accidents. Autopsy findings reveal that extradural hemorrhage is most accurately detected antemortem, while subarachnoid hemorrhage is frequently missed.

Keywords:
Antemortemautopsyhead injurypostmortemtraumatic brain injury

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Area of Science:

  • Medical imaging
  • Forensic pathology
  • Trauma care

Background:

  • Head injuries are a significant cause of mortality.
  • Accurate correlation between clinical, imaging, and autopsy findings is crucial for improving patient outcomes.

Purpose of the Study:

  • To correlate autopsy findings with clinical presentation and imaging reports in fatal head injury cases.
  • To assess the diagnostic accuracy of antemortem evaluations for different types of intracranial hemorrhages.

Main Methods:

  • A descriptive study was conducted on 303 fatal head injury patients over 17 months.
  • Autopsy findings were used as the gold standard to correlate with antemortem clinical and imaging data.
  • Data were analyzed using EpiData and OpenEpi software.

Main Results:

  • Road traffic accidents accounted for 88% of fatal head injuries.
  • Subarachnoid hemorrhage (SAH) was the most common autopsy finding (81.3%).
  • Extradural hemorrhage (EDH) showed the highest diagnostic accuracy (98.35%) and specificity (100%), while SAH had the lowest accuracy (45.72%). Significant subdural hemorrhage (SDH), SAH, and brain contusions were often missed antemortem.

Conclusions:

  • Half of the fatal head injury patients died within 24 hours of reaching the tertiary care center.
  • Antemortem detection of EDH is highly accurate, but SAH and SDH are frequently underdiagnosed.
  • Improved imaging interpretation, clinical examination, documentation, and early resuscitation are vital to reduce missed injuries.