The Study of the Characters of Traumatic Brain Injuries (TBI) in Blunt Head Trauma Caused by Velocity-Related Injuries
Journal Title: Vajira Medical Journal: Journal of Urban Medicine - Year 2022, Vol 66, Issue 3
Abstract
Objectives: To determine the characters of traumatic brain injuries (TBI) related to the occurrence of coup-contrecoup phenomenon in blunt head trauma from velocity-related injuries Methods: The prospective case control study was conducted in Thai postmortem cases sent for autopsies at the Department of Forensic Medicine, Siriraj Hospital, Mahidol University between 11th February 2021 and 31st December 2021. Subjects recruited had the age of 18 years old or over and were dead from traffic accident or falling from height. Data including sex, age, height and weight, configurations of skull, sites of scalp contusion, skull and skull base fracture, brain weight, epidural and subdural hemorrhage, coup-contrecoup contusion and macroscopic spot hemorrhage in white matter were recorded. The comparison of the characters of TBI between the presence and the absence of coup-contrecoup phenomenon was analyzed using descriptive statistics, independent sample t-test, Mann-Whitney U test and contingency table Chi-square test. Results: There were 60 subjects recruited in this study (30 subjects with coup-contrecoup contusion and 30 subjects without coup-contrecoup contusion). The mean age and body mass index (BMI) between these two groups were not significantly different. The configurations of skull were also not significantly different for both temporal and occipital impacts. Brain weight in coup-contrecoup group was significantly greater than that in no coup-contrecoup group (1366.33 ± 84.42 g vs 1275.33 ± 105.63 g, p=0.001). Skull fracture with simple pattern, base of skull fracture without sella turcica involvement and subdural hemorrhage were significantly associated with the presence of coup-contrecoup contusion (p=0.027, p<0.001 and p=0.002, respectively). Conclusion: Brain with coup-contrecoup contusion had significantly higher brain weight than brain without coup-contrecoup contusion. The presence of coup-contrecoup contusion was influenced by the characters of skull and base of skull fracture and the presence of subdural hemorrhage.
Authors and Affiliations
Nathathai Suvitsakulwong Peerayuht Phuangphung
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