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Abstract
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Background. Traumatic brain injuries (TBI) remains one of the leading causes of high mortality both in Europe and globally. The age of people with head injury tends to change, in recent years an increased incidence among the elderly has been observed, especially due to falls. Medico-legal autopsy is mandatory in all head trauma patients, not only revealing the contributions of the injury in the occurrence of death but also in providing information about the pathological mechanism of trauma. Aims. This study aims to describe autopsy findings in patients with TBI and to compare them with primary CT findings, using imagistic investigations reports and clinical data.
METHODS. We included in the study 479 autopsies performed between January 2017 and December 2018 at "Mina Minovici" National Institute of Legal Medicine, Bucharest, in which craniocerebral trauma was a cause in the chain of events leading directly to death. Data were collected from autopsy reports and medical records.
RESULTS. In our study the analyzed population was represented by men in proportion of 76.2% and the most affected age group was between 61 and 80 years. The most common cause of TBI were road accidents (n=137/479; 28.60%) followed by falls from the same level (n=136/479; 28.39%). In the studied group the average survival time was 79.83 days. The most common autopsy findings were cerebral oedema (n=443/479, 92.5%) and subarachnoid haemorrhage (n=425/479, 87.7%). Comparative analysis of 190 cases of TBI showed that only 59.8% of the autopsy findings were diagnosed by antemortem primary CT investigation.
CONCLUSIONS. TBI patterns and the cause of injury change with age, having high mortality among elderly patients. Medico-legal autopsy is a source of valuable information, referring not only to medical diagnoses but also to the circumstances of traumatic injuries. Antemortem investigations and medical history are useful tools in documenting the progression of a brain injury especially in patients with long-term survival and also in establishing causality between traumatic injuries and death.
Keywords: traumatic brain injury, autopsy, postmortem findings, CT findings
Language: en |