Medico-Legal Comparative Study Between Traumatic and Spontaneous Intracerebral Hemorrhage
Iraqi Postgraduate Medical Journal,
2013, Volume 12, Issue 2, Pages 259-267
Intracerebral hemorrhage may be pathological or
traumatic in nature. It may be primary or
Traumatic intracerebral hemorrhage (TICH) is a subtype of intracranial hemorrhage that occurs
within 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 brain
parenchyma in the absence of trauma or surgery.
The aim of this study is to determine the frequency of fatal traumatic and spontaneous intracerebral
hemorrhage, and to differentiate between them in postmortem examination.
This cross-sectional study is performed in the medico-legal institute of Baghdad for (6) months
duration from (1-10-2011) to (1-4-2012). Complete medico-legal history was obtained, and full
proper autopsy including external and internal examination of all corpuses was performed specially
The study included (38) cases of intracerebral hemorrhage; (27) of them were (TICH). Their ages
ranged 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, while
spontaneous group were females and older age. The most common cause of head injuries in the
traumatic group was "missiles" followed by road traffic accidents. Comminuted fractures were the
most common type of skull fracture. Brain laceration and contusion were the two most frequently
observed associated lesions in the traumatic cases. The "intraventricular"
Site was the most frequent in traumatic group, while the "Basal ganglia" was the most frequent in
the spontaneous group. The anterior cerebral artery was the most frequently affected artery in
traumatic group, while the middle cerebral artery was the most frequently affected artery in
we identified seven basic rules that can be used during autopsy examination in all cases of
intracerebral hemorrhage to differentiate easily between traumatic and spontaneous intracerebral
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