1MD, DNB Forensic Medicine & Toxicology, Professor Forensic Medicine, SHKM Government Medical College, Nalhar, Nuh, (India)
2MD Forensic Medicine & Toxicology Assistant Professor, Forensic Medicine, SHKM Government Medical College, Nalhar, Nuh, (India)
3MD Radiodiagnosis Senior Professor Radiodiagnosis, Pt. B. D. Sharma PGIMS, Rohtak, (India)
4MD, DNB Forensic Medicine & Toxicology, Associate Professor Forensic Medicine, VMMC & Safdarjung Hospital, New Delhi, (India)
*Corresponding Author Dr Hitesh Chawla, Professor, Department of Forensic Medicine & Toxicology, SHKM Govt. Medical College, Nalhar, Nuh, (Haryana), India, Mobile: +91-9996530900, Email: drhiteshchawla@gmail.com
Online published on 23 March, 2021.
In the current prevalent practice at trauma centers, axial non-contrast computerized tomography scan (CT scan) is the preferred diagnostic procedure in the traumatic head injury. In many patients, a CT scan might look normal, yet the patient may have a poor Glasgow Coma Scale and have an unfavourable outcome.
To compare and correlate the initial CT scan head after head trauma with autopsy findings for intracranial haemorrhages in head trauma patients brought for medicolegal autopsy and to investigate evolving pathology in head trauma patients who died.
Retrospective observational study
Intracranial haemorrhages namely extradural, subdural, subarachnoid, intracerebral haemorrhages were observed and noted if any, along with contusions in the sixty subjects who had died following head trauma and subjected to medicolegal autopsy over two years. Findings observed for intracranial haemorrhages during the autopsy were compared with antemortem CT scan.
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were determined for CT and autopsy, taking autopsy findings as the gold standard.
Intracerebral haemorrhage was detected in only 6.67% of patients on CT scan, extradural in 26.66%, subarachnoid 40.48%, and subdural in 71.05% patients on CT scan when compared with autopsy. The duration between radiological examination and death was more than four days in majority (38.3%) of cases; while only 28.3% of patients died within 24 hours of radiological examination.
Normal CT scan immediately after the trauma doesn’t exclude the possibility of delayed intracranial haemorrhage.
CT scan, Intracranial haemorrhages, Autopsy, Head injury, Trauma
