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CODE: 1092
 

THE CORRELATION BETWEEN SKULL FRACTURES AND INTRACRANIAL LESIONS DUE TO TRAFFIC ACCIDENTS

 

 

Yavuz MS, Asirdizer M, Cetin G, Gunay Balci Y, Altinkok M.

 

The American Journal of Forensic Medicine and Pathology, 2003; 24(4): 339-45

 

 

ABSTRACT

 

In this study, it was aimed to investigate the relationship between skull fractures and intracranial lesions following head injury. For this purpose, 500 cases, which were referred to the Third Committee of Council of Forensic Medicine in Istanbul due to traffic accidents by the courts of laws between 1998 and 2000, were examined retrospectively. They were categorized in three groups based on findings of their cranium X-rays and brain tomographies. 1- The cases who have fractures in skull bones with brain lesions 2- The cases who have fractures in skull bones with no brain lesions 3- The cases who have brain lesions with no skull fractures. They were examined in detail according to age, sex, localization of skull fractures and brain lesions, and if surgery was applied or not.

 

Of the cases, 152 (30.4%) had only linear fractures, 69 (13.8%) had depressed fractures, 92 (18.4%) had linear fractures plus intracranial lesions, 49 (9.8%) had depressed fractures plus intracranial lesions and 138 (27.6%) had only intracranial lesions. The rate of intracranial lesion among the cases with the skull fracture was 38.9% (141/362), while the rate of skull fracture among the cases with the intracranial lesion was 50.3% (141/279) (p<0.001). Male to female ratios were 2.4/1 for linear fractures, 5.2/1 for depressed fractures, and 3.5/1 for intracranial lesions. Linear fractures were more frequent among females whereas depressed fractures were often among males (χ˛: 9.68, df: 4, p: 0.046). The mean age was 26.3.  The rate of depressed fractures was higher  the age groups of 0-30 years. (χ˛: 16.28, df: 4, p: 0.003). Depressed fracture in the regions of frontal and parietal and, linear fracture in the regions of temporal and occipital were found at higher rates (p<0.001).

 

In conclusion, we reviewed skull fractures and/or intracranial lesions due to traffic accidents, and found depressed fractures to be more common among males whereas linear fractures to be more common among females and young males. In the male, the skull architecture is thicker and stronger than females and young males. We can state that presence of skull fractures lowers the incidence of intracranial lesions by lowering the intracranial pressure.

 

Key words: Skull fractures, intracranial lesions, correlation.

CITED BY:

1. Journal Forensic Science Abstracts. Section 49. 2004: pp: 75.

 

2. Toro K, Hubay M, Sotonyi P, Keller E. “Fatal traffic injuries among pedestrians, bicyclists and motor vehicle occupants”, Forensic Science International 2005; 151: 151–156.

 

3. Aşırdizer M, Zeyfeoğlu Y, Ziver A. “Celal Bayar Üniversitesi Tıp Fakültesi  Adli Tıp Polikliniği’ ne başvuran trafik kazalarına bağlı yaralanmalar”, Adli Bilimler Dergisi,  2006, 5(3): 15-22.

 

4. Diarra CM. “Les fractures embarrures du crane opérées dans le servıce de chırurgıe orthopédique et de traumatologıe de l’ hôpital Gabriel Touré : étude épidémiologique idémiologique, clinique et thérapeutique”, Thčse. 18 Décembre 2004. pp:69,70,80,81,92.

 

5. Lemieux CE, Fernandes JR, Rao C. "Motor vehicle collisions and their demographics: a 5-year retrospective study of the Hamilton Wentworth Niagara region". J Forensic Sci. 2008 May; 53 (3):709-15.

 

6. Yadav A, Kohli A, Aggarwal NK. "Study of pattern of skull fractures in fatal accidents in northeast Delhi". Medico-Legal Update. 2008; 8 (2): 31-4.

 

7. Chattopadhyay S. "Accidental low velocity atypical missile injury to the head". Am J Forensic Med Pathol. 2008 Dec; 29(4): 334-6.

 

8. Muńoz-Sánchez MA, Murillo-Cabezas F, Cayuela-Domínguez A, Rincón-Ferrari MD, Amaya-Villar R, León-Carrión J. "Skull fracture, with or without clinical signs, in mTBI is an independent risk marker for neurosurgically relevant intracranial lesion: a cohort study". Brain Inj. 2009 Jan; 23(1): 39-44.

 

9. Jacobsen C. "Cranial fractures caused by blunt trauma: Characterization of a medico-legal material and assessment of post-mortem computed tomography". Faculty of Health Sciences, University of Copenhagen. Department of Forensic Medicine Section of Forensic Pathology. Thesis. 02.02.2009. pp: 71, 127.

 

10. Chattopadhyay S. Tripathi C. “Skull fracture and haemorrhage pattern among fatal and nonfatal head injury assault victims – a critical analysis”. J Inj Violence Res, 2010; 2(2): Article in Press

 

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