The Correlation Between Skull Fractures and Intracranial Lesions Due To Traffic Accidents

Abstract

In this study, it was aimed to investigate the relationship between skull fractures and intracranial lesions following head injury. For this purpose, 500 cases, which were referred to the Third Committee of Council of Forensic Medicine in Istanbul due to traffic accidents by the courts of laws between 1998 and 2000, were examined retrospectively. They were categorized in 3 groups based on findings of their cranium x-rays and brain tomographies. 1- The cases who have fractures in skull bones with brain lesions 2- The cases who have fractures in skull bones with no brain lesions 3- The cases who have brain lesions with no skull fractures. They were examined in detail according to age, sex, localization of skull fractures and brain lesions, and if surgery was applied or not. Of the cases, 152 (30.4%) had only linear fractures, 69 (13.8%) had depressed fractures, 92 (18.4%) had linear fractures plus intracranial lesions, 49 (9.8%) had depressed fractures plus intracranial lesions and 138 (27.6%) had only intracranial lesions. The rate of intracranial lesion among the cases with the skull fracture was 38.9% (141/362), while the rate of skull fracture among the cases with the intracranial lesion was 50.3% (141/279) (P < 0.001). Male to female ratios were 2.4/1 for linear fractures, 5.2/1 for depressed fractures, and 3.5/1 for intracranial lesions. Linear fractures were more frequent among females whereas depressed fractures were often among males (chi2: 9.68, df: 4, p: 0.046). The mean age was 26.3. The rate of depressed fractures was higher the age groups of 0-30 years. (chi2: 16.28, df: 4, p: 0.003). Depressed fractures in the regions of frontal and parietal and, linear fracture in the regions of temporal and occipital were found at higher rates (P < 0.001). In conclusion, we reviewed skull fractures and/or intracranial lesions due to traffic accidents, and found depressed fractures to be more common among males whereas linear fractures to be more common among females and young males. In the male, the skull architecture is thicker and stronger than females and young males. We can state that presence of skull fractures lowers the incidence of intracranial lesions by lowering the intracranial pressure.

Fatal traffic injuries among pedestrians, bicyclists and motor vehicle occupants

“…Masson et al [20] found that mortality of pedestrians with severe brain injury was higher than of motor vehicle occupants, although motor vehicle occupants were the largest category of hospital patients treated for traumatic brain injury. Yavuz et al [21] reviewed skull fractures and intracranial lesions due to traffic accidents, and stated that presence of skull fractures lowered the incidence of intracranial lesions by decreasing the intracranial pressure. We confirm earlier reports [22,23] stating that the majority of pedestrian fatalities are due to head impacts.…”

A Comprehensive Study of Fatal Head Injuries among Motorcyclists: A One Year Prospective Study.

“…Among the cases studied, majority were males (77.27%) than females (22.72%). Similarly male predominance were observed by various researchers in their studies [2,3,4,5,6]. The peak incidence was observed in the age group of third and fourth decades (61.36%).…”

Skull fracture and hemorrhage pattern among fatal and nonfatal head injury assault victims - a critical analysis

“…The damage to any tissue by mechanical force depends on the amount of energy absorbed by the tissues. Yavuz et al, 12 in their study showed that the occurrence, degree of deformation and extent of fracture is related to the striking power, area of strike and physical properties of the skull at the point of impact. Presence of a comminuted or depressed comminuted fracture indicates the application of a great amount of force as compared to a fissure fracture.…”