Forensic pathology of head injuries Flashcards
What scale is used to assess head injuries and what factors does this assess?
Glasgow Coma Score
- occular
- motor
- verbal
What are the types of injuries?
Bruises (contusions) Abrasions (scratches/grazes) Lacerations (cuts/tears) Incisions (slashes) Stab wounds (penetrating)
What are the types of skull fracture?
- Linear
- Depressed
- Contra-coup
- Hinge
- Ring
- Diastatic
- Pond
What is an extradural haemorrhage?
- accumulation of blood between skull and dura
- results from torn vessel in meninges
- death caused by cerebral compression or herniation
What is a subdural haemorrhage?
- blood accumulation between inner surface of dura and arachnoid layer
- caused by tear of bridging veins (empty into saggital sinus)
Who is more at risk of a subdural haemorrhage?
- elderly
- alcoholics
What is the common cause and presentation of subdural haemorrhage?
- minor head injury
- headache and confusion within 48h
Where do cerebral contusion usually develop?
- frontal poles
- orbital surfaces of frontal poles
- temporal poles
- cortex adjacent to sylvian fissure
What are cerebral contusion?
superficial bruises of the brain
What is a Coup and Contrecoup injury?
Coup - cerebral injury at point of contact
Contrecoup - injury to surface opposite point of contact
When can a contrecoup occur?
occurs after sudden deceleration
What are the possible sources of bleeding in traumatic subarachnoid haemorrhage ?
- severe contusion/laceration
- skull can tear vessels at base of brain
- rupture if dissection of vertebral arteries
- blood from intraventricular haemorrhage
What chronic problem can subarachnoid haemorrhage cause?
hydrocephalus due to blockage of CSF
What is a lucid interval?
time period between injury and death
What is a diffuse axonal injury and how will it present?
widespread traumatic axonal damage
- unconscious from impact
- no lucid interval
- remain unconscious in veg state or severely disabled
