Demographic profile of head injury cases in Agra region.

Head injury is a serious health problem throughout the world. Increasing vehicles on roads work as catalyst for high incidence of casualties especially of Cranio-cerebral injuries. This is an autopsy based study of head injury cases, conducted in the Department of Forensic Medicine, S.N. Medical College Agra in year 2009-2010 for their demographic and etiological profile. Majority of the victims of head injury are male (76%) and of 3rd – 4th decade of life (54.4%). 66.4% head injury cases due to accident, Road traffic accident is the single largest cause i.e. 59.2%; out of which two wheelers are responsible for one-third (33%) of the casualties. Most common external injury is laceration of the scalp with or without contusion. Fracture of skull bones (97.2% cases; mostly fissured and comminuted fracture of parietal & temporal) and intracranial hemorrhages (96.4%) are seen in almost all the cases. Contre-coup injuries seen in about 2.8% cases, contre-coup haemorrhage observe mostly fronto-temporal area. Majority of the victim died on the spot or in the way to hospital without any medical assistance where the Cause of death mostly haemorrhage and shock.

Correlation of CT scan with postmortem findings of acute head trauma cases at SMS Hospital, Jaipur.

Epidemiological information is of great importance in the allocation of resources for the treatment and in formulating policy designed to reduce the incidence, morbidity and mortality of head injuries. In our country much epidemiological data regarding head injuries are not available, hard to find or inaccurate. The reasons for this are several there is no centrally run health care system in the country and head injury cases are managed by a wide variety of Government, Municipal and Private hospitals. The National Health Statistics compiled in the vital statistics in our country give incomplete information regarding head injuries while it is possible to determine mortality from cancer or heart diseases or number of other illness from vital statistics but same is not true for head injuries. Accidental deaths are catalogued as to etiology (for example, death from falls, motor vehicle etc.) and there is no information available as to the part of the body injured. The present study is an attempt to analyse epidemiological aspects of acute head trauma and evaluate the correlation of finding by various diagnostic modalities.

Fracture of the temporal bone: A tomographic v/s autopsy study.

The present study was conducted in the Dep’t. of Forensic Medicine & Toxicology, SMS Medical College Jaipur (Raj), in the period from 15 Dec. 2001 to 4 April 2002. With the aim to find out the correlation of X-ray (Skull), CT scan (Head), Surgical intervention findings with the autopsy findings in the cases of acute Head trauma. Total of 140 cases of acute head trauma were selected irrespective of age, sex, religion caste etc. who had been admitted in Neurosurgery dep’t. And X-ray, CT scan head and /or surgical intervention had been done, subsequently died & autopsy was performed. X- ray skull gave batter information on fracture of skull than CT Scan, particularly when the fracture is located on the vault or base of skull and is of linear variety [1]. 27 cases of fracture of the temporal bone were specially studied, out of these 140 cases. All these cases had the features of triad, indicating of fracture of petrous part of temporal bone i.e. CSF Otorrhoea 14(51.1%), 7th nerve palsy 9(33.3%), serve middle ear bleeding 18(66.6%) & conducting hearing loss 5(85%). The plain X-ray demonstrated the fracture of temporal bone in 21 cases (79%) and the CT Scan demonstrated their in 24 cases (88%) Longitudinal fractures are common in 18 cases (66%) and procedure of choice for their demonstration is lateral tomography, Transverse fracture alone was uncommon (2 cases) and can only be demonstrated in anterior posterior tomographic projections and is usually associated with occipital fractures. CT Scan Examination give better information in detection of fracture of temporal bone as well as the type of fracture [2] which is essential for planning the surgical intervention or treating the patient conservatively in order to avoid the complications like, persistent CSF otorrhoea, posterior meningitis or even death.

Fracture of the temporal bone: A tomographic v/s autopsy study.

The present study was conducted in the Department of Forensic Medicine & Toxicology, SMS Medical College Jaipur (Raj), in the period from December 15, 2001 to April 4, 2002. With the aim to find out the correlation of X-ray (Skull), CT scan (Head), surgical intervention findings with the autopsy findings in the cases of acute Head trauma. Total of 140 cases of acute head trauma were selected irrespective of age, sex, religion caste etc. who had been admitted in Neurosurgery dep’t. And X-ray, CT scan head and /or surgical intervention had been done, subsequently died & autopsy was performed. X- ray skull gave batter information on fracture of skull than CT Scan, particularly when the fracture is located on the vault or base of skull and is of linear variety. [1] Twenty seven cases of fracture of the temporal bone were specially studied, out of these 140 cases. All these cases had the features of triad, indicating of fracture of petrous part of temporal bone i.e. CSF Otorrhoea 14(51.1%), 7th nerve palsy 9(33.3%), serve middle ear bleeding 18(66.6%) & conducting hearing loss 5(85%). The plain X-ray demonstrated the fracture of temporal bone in 21 cases (79%) and the CT Scan demonstrated their in 24 cases (88%) Longitudinal fractures are common in 18 cases (66%) and procedure of choice for their demonstration is lateral tomography, Transverse fracture alone was uncommon (2 cases) and can only be demonstrated in anterior posterior tomographic projections and is usually associated with occipital fractures. CT Scan Examination give better information in detection of fracture of temporal bone as well as the type of fracture [2] which is essential for planning the surgical intervention or treating the patient conservatively in order to avoid the complications like, persistent CSF otorrhoea, posterior meningitis or even death.

A study of the pattern of head injury in District Aligarh. U.P.. India.

Trauma as a general rule carries medicolegal implication. Head injury adds complexity to the problem as it adversely affects the complete evaluation of trauma until some time has elapsed after a particular injury. The often ill-defined clinical manifestation, the impact of claim settlements, and malingering further add to the problem of fair decision.

Pattern of fatal head injuries due to vehicular accidents in manipal.

Head injury is an important cause of mortality worldwide as head is the most vulnerable part of the body involved in fatal road traffic accidents. The present study was undertaken on 100 victims of Road Traffic Accident who died due to injuries sustained to the head, which were autopsied at Kasturba Medical College, Manipal over a period of 3 years between January 1995 and December 1997. Most of the accidents had taken place in the afternoon hours (12.01 - 18.00 hrs). There was a marked male preponderance (89 %). The most vulnerable age group to accidents was found to be 21 to 30 years. Both pedestrians and occupants were equally involved. Two-wheeler occupants were most commonly involved. Head injury was present in 82 % of cases with skull fracture in 62 %. Fracture of the vault was found in 38 %, base of the skull in 34 % and both in 28 % of cases. In most of the cases, fissured fracture was found (57 %). Among intra-cranial haemorrhages, subdural haemorrhage was found in 77 % and subarachnoid haemorrhage in 55 % of cases. Contusions and lacerations of brain were found equally in 35 % of cases.