Clinicopathologic observations in 100 consecutive patients with fatal head injury admitted to a neurosurgical unit

A neuropathologic study of 100 patients with fatal head injuries admitted to a neurosurgical unit revealed hypoxic-ischaemic brain damage in 74% and diffuse axonal injury in 42% of patients respectively. Of the seven patients who died as a result of extracerebral injuries, there were four in whom death due to hypovolaemic shock, was considered potentially avoidable. This study indicates that there is scope for improvement in the management of patients with acute head injury, particularly in the prevention of secondary brain damage, and in the need to increase awareness of potentially life threatening extracerebral injuries as a cause of coma.