Fatal craniocerebral injuries in victims who survived for some period

It is a prospective study of 50 fatal head injury cases whose medico legal autopsy was done in the Institute of Forensic Medicine, Madras Medical College and Government General Hospital, Chennai from December 2007 to June 2008. There were total 50 cases of fatal craniocerebral injuries which needed admission either in Intensive Care Unit or neurosurgery. In the present study, male victims (47 cases, 96%) outnumbered female victims (3 cases, 6%) with an approximate male-female ratio of 16:1. Road traffic accidents (RTA) involving mainly pedestrians and two wheeler users were the most common cause of fatal head injury, seen in 43 cases (86%). Out of the total 50 cases of fatal head injury, brain stem injury was seen in 41 cases (82%). Skull bone fracture was found in 26 cases (52%), 11 cases were associated with primary brain stem injury and 15 cases with the secondary brain stem injury. Temporal and parietal bones were the common site of fracture, observed in 17 cases (34%). The range of survival period was wide, spreading from 6 hours to 600 hours; the mean survival period being 73.42 hours. Brain stem injury, which is generally associated with skull base fracture, was found to be the main factor governing the prognosis of the case.