PATTERN OF SKULL FRACTURES AND INTRACRANIAL HEMORRHAGES IN FATAL BLUNT FORCE HEAD TRAUMA: AN AUTOPSY STUDY FROM THE MAHAKAUSHAL REGION, CENTRAL INDIA

Abstract

Background: Blunt force head trauma is a leading cause of mortality in medico-legal practice. The interplay between skull fractures and intracranial hemorrhages provides vital clues for establishing the cause of death and reconstructing the mechanism of injury.
Methods: A prospective autopsy-based study was conducted on 600 cases of fatal blunt force head injury at N.S.C.B. Medical College, Jabalpur. Detailed analysis included demographic profile, cause of injury, fracture type and site, and intracranial hemorrhage distribution. Correlations between fracture site/type and hemorrhage patterns were evaluated.
Results: The majority of victims were male (80%) with peak incidence in the 21–40 year age group. Road traffic accidents (RTA) accounted for 58.33% of cases, followed by falls (29%), railway accidents (9%) and assaults (3%). Linear fractures were the most common (51.74%), followed by comminuted (22.46%), chrushed (6.32%) and depressed (4.43%). Temporal bone was the most frequently fractured site (40%). Subarachnoid hemorrhage (92.6%) was the leading intracranial lesion, followed by subdural hemorrhage (82.1%), extradural hemorrhage (9.8%), and intracerebral hemorrhage (8.3%). Coup injuries were observed in 34% of cases, contre-coup in 41%, and both in 25%. A strong correlation was found between temporal bone fractures and EDH, while frontal and parietal fractures were more often associated with SDH and SAH.
Conclusion: Temporal bone fractures and subarachnoid hemorrhage were the predominant findings in blunt force trauma deaths. These patterns underscore the forensic significance of correlating external injuries, fracture morphology, and hemorrhage distribution in death investigation.