Morphological Patterns of Traumatic Head Injury in Medicolegal Autopsies at Muhimbili National Hospital, Dar ES Salaam Tanzania

Morphological Patterns of Traumatic Head Injury in Medicolegal Autopsies

Abstract

Introduction: Head injury is predicted to surpass many diseases as a major cause of death and disability by the year 2020. There is a limited documentations on morphological patterns of traumatic Head Injury and its prevalence specifically in Medical legal Autopsy in Tanzania population. The aim of this study was to determine the morphological patterns of Traumatic Head Injury (TBI) in Medical legal autopsies seen at Muhimbili National Hospital (MNH). Subjects and Methods: This was a hospital based cross-sectional study conducted at MNH mortuary. The postmortem examination was performed under Virchow method on 170 cases of TBI in which morphological patterns of TBI was recorded. Proportional of TBI frequencies on various morphological patterns in medical legal autopsies were recorded. Association between cause of death and etiology of TBI were established by Fisher-exact test. Results: The proportion of TBI among the medico-legal autopsy at MNH was 38.5%. All cases of TBI had scalp abrasion, and the majority had linear fracture 67(39.3%) and the commonest the parietal bone was commonly affected 85(55.6%). In closed TBI, majority had subarachnoid hemorrhage130 (84.9%). All cases of TBI had brain edema, with one coincidental finding of metastatic adenocarcinoma. A total of 42 cases of TBI had brain herniation, 51 brain laceration and 52, had brain contusion.  The association between etiology of injury, wearing helmets among motor cycle user and cause of death was statistically significance (p<0.05).  Conclusion: The higher proportion of TBI among medicolegal autopsies at MNH reflects the burden of head injury in our settings.