Journal of Emergencies, Trauma, and Shock
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 Table of Contents    
EDITORIAL  
Year : 2018  |  Volume : 11  |  Issue : 3  |  Page : 153
Whats new in emergencies trauma and shock? Autopsy in fatal head injuries


1 Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
2 Department of Neurosurgery, RED LATINO, Organización Latinoamericana de Trauma y cuidado Neurointensivo, Bogota, Colombia

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Date of Submission02-Jan-2018
Date of Acceptance09-Jan-2018
Date of Web Publication01-Oct-2018
 

How to cite this article:
Agrawal A, Moscote-Salazar LR. Whats new in emergencies trauma and shock? Autopsy in fatal head injuries. J Emerg Trauma Shock 2018;11:153

How to cite this URL:
Agrawal A, Moscote-Salazar LR. Whats new in emergencies trauma and shock? Autopsy in fatal head injuries. J Emerg Trauma Shock [serial online] 2018 [cited 2018 Dec 11];11:153. Available from: http://www.onlinejets.org/text.asp?2018/11/3/153/242524




Autopsy is considered as a gold standard to understand the pathological changes responsible for fatal outcome in head injury;[1],[2] however, no one will wish to have increase in the numbers. In the present study, the authors describe the autopsy findings in fatal head injury victims and correlate with the clinical picture and imaging report.[2] The study [2] supports the existing evidence that the most of victims were young males in their productive age group and sustained a fatal head injury in road traffic accidents and only few of them reached the hospital in golden hour (in the present study, only 8% met the same).[3],[4],[5],[6],[7] It is interesting to note that all these patients were alive at the time of presentation to the hospital but sustained fatal injuries in varying severity and combinations.[2]

It is also worrisome to note that almost 50% of the victims sustained head injury alone (most of them sustained severe head injury, 77.2%), which suggested a diffuse injury to the brain (i.e., Subarachnoid hemorrhage (SAH) and acute subdural hematoma (SDH), etc.,) and almost 50% succumbed to the injuries within 24 h of the admission to the hospital.[2] Another concern is that 50% of the victims had injuries to the chest, abdomen, and long bones [2] which are known to worsen the outcome in these patients.[3],[5],[6],[8]

The central nervous system injuries were responsible for up to 40%–50% fatalities in one series,[1] and in another series, 31.51% victims sustained isolated which resulted in fatal outcome.[8] The authors highlight very well that the best strategy will be reducing the number of injuries by implementing preventive strategies or providing better prehospital care and early definitive management to improve the outcome on injured victims. The limitation of this study is that we do not know that how patients were dead at the time they reached the hospital and how many were died at scene or before reaching the hospital.



 
   References Top

1.
Buschmann CT, Gahr P, Tsokos M, Ertel W, Fakler JK. Clinical diagnosis versus autopsy findings in polytrauma fatalities. Scand J Trauma Resusc Emerg Med 2010;18:55.  Back to cited text no. 1
    
2.
Alexis RJ, Jagdish S, Sukumar S, Pandit VR, Palnivel C, Antony MJ. Clinical Profile and Autopsy Findings in Fatal Head Injuries. J Emerg Trauma Shock 2018;11:206-11.  Back to cited text no. 2
    
3.
Kalougivaki JJ, Goundar RP. Retrospective autopsy based study of fatal road traffic accidents in Fiji. J Forensic Res 2014;5:1.  Back to cited text no. 3
    
4.
Tien H, Chu PT, Brenneman F. Causes of death following multiple trauma. Curr Orthop 2004;18:304-10.  Back to cited text no. 4
    
5.
Faduyile F, Emiogun F, Soyemi S, Oyewole O, Okeke U, Williams O, et al. Pattern of injuries in fatal motorcycle accidents seen in Lagos State University teaching hospital: An autopsy-based study. Open Access Maced J Med Sci 2017;5:112-6.  Back to cited text no. 5
    
6.
Ninave S, Agrawal A, Tirpude B, Anjankar A, Ninave S. Injury distribution on autopsy in cases of fatal Cranio-cerebral injuries: An experience from rural central India. J Forensic Med Toxicol 2011;28:6.  Back to cited text no. 6
    
7.
Tandle RM, Keoliya A. Patterns of head injuries in fatal road traffic accidents in a rural district of Maharashtra – Autopsy based study. J Indian Acad Forensic Med 2011;33:228-31.  Back to cited text no. 7
    
8.
Kumar A, Lalwani S, Agrawal D, Rautji R, Dogra T. Fatal road traffic accidents and their relationship with head injuries: An epidemiological survey of five years. Indian J Neurotrauma 2008;5:63-7.  Back to cited text no. 8
    

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Correspondence Address:
Dr. Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JETS.JETS_2_18

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