Analysis of cranio-cerebral injuries by blunt force.

Despite current advances in public education and in automobile safety requirements, cranio-cerebral injuries continues to be a major cause of morbidity and mortality and accounts for significant portion of health care costs today. Trauma respects neither geography nor body systems. Consequently head injury occurs every 15 seconds and a patient dies from a head injury every 12 minutes, a day doesn’t pass that an emergency department physician is not confronted with a head injured patient. The present work is based on the observation and study made on 117 cases collected. These cases include 39 cases who died before being admitted to any hospital and were sent directly by the police to postmortem, Mysore Medical College, Mysore, and 78 cases that died in the hospital under medical care. Clinical data are available for 78 cases that died in the hospital after undergoing some treatment. An attempt is made in these cases to correlate clinical findings with the autopsy findings.

Pattern of fatal blunt head injury: A two year retrospective / prospective medico legal autopsy study.

The current study was conducted from 1 November 2002 to 31 October 2004 at Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai. A total of 189 victims of fatal blunt head injury were recorded and a complete medicolegal autopsy was conducted on each of these victims during this period. The postmortem study revealed that males were the most common victims with the highest number being in the age group of the third and fourth decades. Accidents were responsible for most of them, followed by homicidal deaths, with suicides recorded as the least. Of the accidents, railway accidents were responsible for the maximum number. The study revealed that the highest number of fatalities occurred during the peak hours of the day. The fissured fracture was the most common type of fracture observed. Among the specialized fractures of the base of the skull, type-1 hinge fracture was the most common. A combination of subdural and subarachnoid haemorrhages was the most common observation. Blunt cranio-cerebral injury was the primary cause of death in more than half of the victims

Pattern of motorcyclist's mortality in Mazandran province, northern Iran

Road traffic accidents [RTA] is recognized internationally as the major threat to human health and, motorcycle collision victims form a high proportion of those killed or injured in RTA.This study was performed to evaluate the patterns of motorcyclist's mortalities. All motorcyclists' corpses that were presented to the legal medicine center of Mazandaran Province during January 2002 to January 2004 were enrolled and the patterns of motorcyclist's mortalities were determined. Of the 89 bodies, 93.3% were male and 84.2% were riders. About 60% sustained injuries from collision with a car. Two third of the deaths occurred in the first half of the year. Three fourth of the death occurred in heavy traffic volume time of a day [7 am to 10 pm] peaking at 9 pm [21%]. Fifty seven percent died on the rural roads collisions and 47% on the urban road collisions. Head injury was the main cause of death [50.6%]. Motorcyclist's mortalities were prevalent in young motorcycle riders [males], collision with a car, first half of the year, heavy traffic volume time, riding on rural roads, and head injury was the main cause of death

Foreign objects in genitalia: Homicide with destruction of identity –A case report.

Sadistic homicides are probably more common than would be expected from reading the literature, where only a few cases are mentioned. In the present case an unclothed dead body of 25 year old female was found in the forest area by the police. On postmortem examination, we found crushed head by heavy hard blunt force (a heavy stone with blood stains recovered near body). After killing her, assailants tried to destroy her identity by burning the face and disfiguring the head. In this case beside common findings of homicide as usually seen in sexual murder cases; there was unique finding of a wine bottle introduced into vagina probably out of frustration. Body also had postmortem abrasions over different parts of the body. Postmortem fractures of multiple ribs were present on both sides of the chest. The death was due to crushed injuries to head caused by hard blunt force, which was sufficient to cause death in ordinary course of nature. We also discuss the possible scenario of psycho-pathology of accused in such cases.

Comparison of two surveys of head injured patients presenting during a calendar year to an Urban medical centre 32 years apart

To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003. During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre [JPMC] with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented. During the year 2003, a total of 3008 patients reported to the emergency room of JPMC. Of these 67% were males and the majority of the reporting patients [48%] had suffered their head injury in falls from a height. However, when considering the seriously injured patients warranting admission to the neurosurgery unit, road traffic injuries predominated [54%] and the age distribution was weighed towards an older age group with 70% being above the age of 20 years and mainly in the economically active 4th decade of life. One hundred and fifty four patients died for a mortality rate of 5% in the entire series of 3008 patients and 25% of the 623 admitted patients. The experience of head injuries reporting to our centre in two calendar years, 33 years apart, suggests that this attention to the crisis of death and disability occurring on roads is necessary