Prevention of head trauma and death in patients with head injuries: A forensic autopsy study

Abstract This forensic study investigated patients with head injury to find methods of preventing head trauma and death of patients with head injuries. Autopsy information of patients who died after experiencing blunt force trauma in the head owing to different causes was reviewed. In addition, the manners of the death of patients who had mild to moderate head injuries on admission were analyzed. The records of 68 adult patients (2008–2015) with skull fractures or traumatic intracranial lesions due to blunt force trauma were assessed in this study. These patients were divided into four groups according to the causes of trauma: traffic accidents ( n  = 20), simple fall ( n  = 18), fall from height ( n  = 23), and blow ( n  = 7). The demographic information (Glasgow coma scale [GCS] score on admission and current medication and fall histories), autopsy findings, and severity of the injury, as indicated by the Abbreviated Injury Scale and Injury Severity Score, were compared among the different groups. The causes of death of seven patients with mild (GCS score of 13–15) or moderate (GCS score of 9–12) head injuries on admission were analyzed. The numbers of patients with current medication, fall history, subdural hematoma, and head injury alone as the cause of death were significantly higher in the simple fall group. The incidence of skull fractures and the number of deaths from multiple head and trunk injuries were significantly higher in the traffic accident group. Of the seven patients with mild or moderate head injuries on admission, four and three died from the acute onset of a pre-existing condition and exacerbation of traumatic brain injury, respectively. These results indicate that preventions of simple falls in individuals with current medication or fall history may decrease the number of deaths due to simple falls, and patients with head injuries due to traffic accidents should be examined for coexisting trunk injuries; in addition, those with mild or moderate head injuries must be cautiously monitored for the onset of a pre-existing condition and exacerbation of traumatic brain injury.