Frequency of intracranial injury in cadavers with head trauma with and without scalp injury in Tehran

Traumatic brain injury is a major cause of morbidity, disability and mortality in patients with head injury. The aim of this study was to elucidate the frequency of intracranial injury in cadavers with head trauma with and without scalp injury in Tehran. In this analytical cross-sectional study, we investigated 187 cadavers who died due to head trauma in motor vehicle accident or after falling in Tehran from November 2013 to February 2014. Age, sex, mechanism of trauma, scalp injury, sub-scalp bruising, skull fracture, hemorrhage including subdural hemorrhage (SDH), epidural hemorrhage (EDH), subarachnoid hemorrhage (SAH) and contusion were recorded from examination and autopsy. One hundred and eighty seven cadavers (165 (88.2%) male and 22 (11.8%) female) with head injury with the mean age of 36.14 years (SD = 15) were recruited in this study. Mechanism of trauma was motor vehicle accident in 147 (78.6%) cadavers and falling in 40 (21.4%) cadavers. One hundred and fifty eight (84.5%) had SDH, 44 (23.5%) had EDH, 162 (86.6%) had SAH and 139 (74.3%) had contusion. Hemorrhage was seen in 132 (93%) cadavers who had scalp injury and 36 (80%) cadavers who did not have scalp injury (p = 0.01). Overall, 168 (89.8%) cadavers had hemorrhage and 139 (74.3%) had contusion. There was a significant correlation between intracranial injuries and scalp injury (p < 0.05). There was not a significant correlation between EDH and scalp injury (p = 0.52). Consequently, in patients with head trauma, complete examination should be performed but absence of findings in examination cannot exclude intracranial injury. (C) 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.