Study of skull fractures in fatal cranio cerebral injuries in light with the manner of death

Brain damage, as a result of head injury, constitutes a hidden epidemic and is a major problem worldwide. It is the most common emergency encountered in trauma units and the casualty department.

The present study was conducted at the central morgue, Department of Forensic Medicine and Toxicology, SCB Medical College, Cuttack, Odisha, during the period from September 2010 to August 2012 and included 200 cases of fatal cranio cerebral injuries.

Among all fatal cranio cerebral injuries 87% cases were non homicidal and rest 13% were homicidal cases. The commonest skull bone involved was parietal followed by temporal, frontal and occipital, respectively. The incidence of fissured fracture was the commonest, followed by comminuted, depressed and cut fractures. Extradural haemorrhage was absent in both homicidal and non homicidal deaths when there was no associated fracture of the skull bone.

In all categories of craniocerebral injuries, skull fracture was noticed to have a definite association with brain injury in comparison to brain involvement without fracture skull. The overall frequency of intracranial hemorrhage was more in association with skull fracture than without skull fracture. The definite role of skull fracture in craniocerebral injuries can be explored in deciding the fatality and the manner of the cases.