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.

Heat induced morphological changes in the brain.

In severe conflagration the terminal state of the body often does not reflect the condition at the time of death. Some-times death might have occurred before any heat reaches the body and the death might have been caused by inhalation of smoke. It is difficult or rather impossible for the forensic expert to determine the extent of ante-mortem damage caused by flames. The classical distinction of “red flare or vital reaction” are usually absent in such cases. Destruction of the victim by fire is one of the oldest methods used by murderers to conceal their crime, and hence every death by burning require the most meticulous medico-legal scrutiny. Here we report an unusual cases of heat induced morphological changes in brain in a 60 years male, who was addicted to alcohol and smoking and found burnt on his bed in a locked room from inside. Typical vital reaction was not appreciable anywhere on the body so as to frame the opinion in favour in ante-mortem burns but on of dissection of skull certain unusual gross pathological finding was observed which helped in framing the opinion in favour of “Death due to accidental antemortem flame burns”.

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.