Medico-Legal Comparative Study Between Traumatic and Spontaneous Intracerebral Hemorrhage


BSTRACT: INTRODUCTION:Intracerebral hemorrhage may be pathological ortraumatic in nature. It may be primary orsecondary BACKGROUND: Traumatic intracerebral hemorrhage (TICH) is a subtype of intracranial hemorrhage that occurswithin the brain tissue itself and lead to displacement or destruction of brain tissue with high rate.Spontaneous intracerebral hemorrhage (SICH) is defined as a blood clot that arises in the brainparenchyma in the absence of trauma or surgery. OBJECTIVE: The aim of this study is to determine the frequency of fatal traumatic and spontaneous intracerebralhemorrhage, and to differentiate between them in postmortem examination. METHODS: This cross-sectional study is performed in the medico-legal institute of Baghdad for (6) monthsduration from (1-10-2011) to (1-4-2012). Complete medico-legal history was obtained, and fullproper autopsy including external and internal examination of all corpuses was performed speciallythe head. RESULTS: The study included (38) cases of intracerebral hemorrhage; (27) of them were (TICH). Their agesranged between (5 –65) years, and (11) of them were (SICH) with an age ranging between (15 –75)years. Traumatic group was associated with male preponderance and younger age, whilespontaneous group were females and older age. The most common cause of head injuries in thetraumatic group was "missiles" followed by road traffic accidents. Comminuted fractures were themost common type of skull fracture. Brain laceration and contusion were the two most frequentlyobserved associated lesions in the traumatic cases. The "intraventricular" Site was the most frequent in traumatic group, while the "Basal ganglia" was the most frequent inthe spontaneous group. The anterior cerebral artery was the most frequently affected artery intraumatic group, while the middle cerebral artery was the most frequently affected artery inspontaneous group. CONCLUSION: we identified seven basic rules that can be used during autopsy examination in all cases ofintracerebral hemorrhage to differentiate easily between traumatic and spontaneous intracerebralhemorrhage