A study of injuries to circle of willis in cases of fatal road traffic accidents

The present study was undertaken in the Department of Forensic Medicine of MAMC with the objective of studying the injuries to Circle of Willis.

100 cases of death due to road traffic accidents were studied using the standard autopsy procedure: Circle Of Willis was visualized after injecting Indian ink in the basilar artery. Out of these, 99 cases had external injuries namely abrasion, contusion and laceration present over the head. Contusion was the most common injury to scalp with frontal region being the commonest site.

Skull fracture was seen in 74 (74%) cases. Combination of fracture of vault and base of skull was the commonest type comprising of 35 cases (47.2%).

Among the intracranial injuries, subarachnaiod hemorrhage was the commonest, present in 90 (90%) cases, followed by subdural hemorrhage in 79 cases. Laceration of brain was present in 6 cases (6%).

In two cases the Circle of Willis was damaged. Out of these one had rupture of left anterior communicating artery along with left anterior cerebral artery. There was no associated fracture in this case. In the other case there was rupture of left anterior communicating artery, middle cerebral artery, left anterior artery, left posterior communicating artery associated with fracture of left frontal and temporal bone along with comminuted fracture of left cranial fosse. The decrease in incidence of injuries to Circle Of Willis was due to fact that vessels of Circle of Willis are remote from the skull surface and lie deeply protected under the buffer provided by the mass of brain. (B. Knight)