Medico-Legal Study of Intracranial Causes of Death

A lot of causes related to the head region that could lead to death, but for simplicity these causes are of two broad categories either natural (non-traumatic) or violent (traumatic).Intracranial contents of skull may be affected by one or more of the previous categories. Pathological causes could be tumors, cysts, hemorrhages, ischemias, infections .etc.While traumatic causes are of wide range.Objectives. To classify all intracranial lesions and injuries according to the mode and manner of death, gender, age and admission to hospital and evaluate these lesions and their role in causation of death.
Materials and methods.The study was performed on 119 cases referred to the Medico-Legal institute in Baghdad within the period of the study from 1st November 2012 to 1st May 2013. Information about each case was taken from close relatives, medical archives and police reports. Digital photography and X-rays were done for interesting cases. Complete routine autopsy was carried-out for all cases with thorough external and internal examination. Tissue specimens were sent for histopathology and blood samples were withdrawn for alcohol and toxicology.
Results.In this study intracranial lesions were ccounting for 11.54% from total deaths referred to the Medico-legal Institute in Baghdad within the period of the study. Medical history was negative in majority of cases and ischemic heart disease was the commonest medical problem .The mean age was 32.48+_17.597 SD.The commonest age group affected by the intracranial lesions was >20-30 years. Traumatic cases were the commonest .There was insignificant correlation between mode of death and age. Males presented in 67, 23% while females were presented in 32, 77% of the cases. There was insignificant correlation between gender and mode of death. In traumatic deaths, road traffic accidents were the commonest categories of death while in the non-traumatic deaths cerebrovascular accidents were represented in 9, 24% of all cases. Accidental type of death was the commonest. The study showed that intracranial lesions alone were seen in 27, 73% of the cases. Spontaneous subarachnoid hemorrhages were the commonest intracranial lesions. Fractures were the commonest external injury. Injuries to both spleen and lungs were the commonest internal organs injuries. Pneumonia represents the commonest complication. Conclusions.•Males were affected more than females with males: females ratio 2:1. Ischemic heart diseases were the commonest associated medical history. •The commonest age group affected by the intracranial lesions was >20-30 years and the least group affected was >70 years. Most of cases were traumatic for both genders and traumatic cases were more common in males than in females with no relation between gender and mode of death.Road traffic accidents were the commonest category of traumatic deaths while cerebrovascular accidents were the commonest category of natural deaths. Accidental type of death was the commonest manner of death and suicidal type was the least common type. Spontaneous intracranial hemorrhages were the commonest intracranial lesions.Spleen and lungs were injured in majority of cases.Meninges were the commonest intracranial structure affected and the subarachnoid hemorrhages were the commonest meningeal findings during autopsy. Lacerations were the commonest brain and brainstem lesions.