The pattern of fatal head injury in a teaching hospital in eastern Nepal. 592-596
Shivendra Jha Assistant Professor Department of Forensic Medicine and Toxicology B. P. Koirala Institute of Health Sciences, Ghopa Camp, Dharan email@example.com 025-525555-Ext 5014(Off); 3293 (Res); Cell- 9852049121
Background : Head injury is an important cause of mortality worldwide, as the head is the most vulnerable part of the body which is involved in fatal road traffic accidents. Objective: To study the pattern of fatal head injury in the victims of road traffic accidents, who presented to the B.P. Koirala Institute of Health Sciences, Dharan, Nepal, which is a focal place for autopsies in the Sunsari district.
Materials and methods: All cases of head injuries in road traffic accident victims, who were autopsied at the B.P. Koirala Institute of Health Sciences, Dharan, Nepal from Feb 2006 to May 2007, were included in the study.
Results: 77 people died in road traffic accidents due to head injuries in the study period. There was a marked male preponderance (78%). The most vulnerable age group was young adults between the ages of 21 - 40 years (38%)).Pedestrians were the most commonly involved victims (48%). Skull fractures were present in 85.7% of the cases. Fractures of the vault were found in 93.9% and those of the base of the skull were found in 57.50% of the cases. Comminuted fractures were found (45.16%) in a maximum number of cases, followed by depressed and linear fractures (38%) in almost the same numbers of cases. Among intra-cranial haemorrhages, subdural haemorrhage was found in 50.6%, extradural in 48% and subarachnoid haemorrhage in 35% of the cases. More than half of the victims (57.1%) suffered injury to the cerebrum and 18.1% victims to the cerebellum. Contusions and lacerations of brain were found equally (35%) in the cases.
Conclusion: Injuries to the skull and brain are the major and significant contributory factors in the causation of the fatalities on the roads, resulting from the accidents.