Autopsy and Histopathological Analysis of 28 Cases of Traumatic Brainstem Haemorrhages

Background: Brainstem hemorrhage was first described by Cheyne in 1812 in a pathological study of patients presenting with lethargy and coma. In 1877 Bode reviewed the findings of 67 patients reported in the literature (1). In the United States, the incidence of closed head injury is estimated to be approximately 200 cases per 100,000 persons per year. The financial burden of head injuries in the United States is estimated to be $75-100 billion annually (4). Materials and Methods: This cross-sectional study, the brainstem was studied by both gross and histopathological examinations. Results: During a period between between July 1, 2010 and June 31, 2011, a total of 71 head injury cases were autopsied and brainstem hemorrhage was seen in 28 of them. Discussion: Out of the 28 cases, most of the hemorrhages occurred in the midbrain (68%) and least in medulla oblongata (11%), while four cases had pontomedullary junction tearing and one of them presented presented cervicomedullary junction tearing. Conclusion: Hemorrhages are usually the only evidence of injury to the brain-stem in those dying immediately or within a few hours. Failure to realize this has led to underestimation of the frequency of brain-stem hemorrhage after injury, and, indeed, to the frequency of brain-stem lesions of all kinds.