Abstract:

Introduction and aim: As emphasized in the previous article, cerebrospinal injury remains the single most important public health problem encountered in industrialized society. Accidents remain the most important cause of injury, disability, and death in modern society. For many years pathologists have recognized the characteristic focal lesions found in fatal head injuries like contusion, laseration and hemorrhage. In recent years the recognition of the diffuse lesions-diffuse axonal injury (DAI), ischemic brain damage and brain swelling more fully explain the pathophysiologic abnormalities that accompany such injuries. Results: Pathologic findings after head trauma could be analyzed under two main groups, focal cerebral parenchymal damage and deep penetrating wounds. Focal cerebral parenchymal damage can be divided into four forms: contusions, lacerations, hemorrhages and cerebral concussion. It is important to evaluate cranial impact in this group with coup contusions on the same site and those opposite the cranial impact, countercoup contusions. Deep brain wounds are caused for the most of the time by firearm injuries. In these cases it is important to determine what type of attack will cause what type of injury. DAI, which may be seen in cases like vehicle accidents, falls, assaults, child abuse is a neuropathological entity developed in brain by acceleration/deceleration traumas and characterized by diffuse white matter degeneration. The lesions seen in DAI cases, may extend a wide spectrum of both macroscopic and microscopic lesions. It is also of great importance to differentiate the lesions triggerred by DAI by forensic patholologists in ongoing cases. Hemorrhages due to craniocerebral trauma can be divided epidural hematoma, subdural hematoma, intracerabral hematoma and subarachnoid hemorrhage. In traumatic hemorrhages, for determination of age of injury, by using histopathological examination has an important impact. Conclusion: It is of exuburant impact to precise evaluation of gross and histopathological analyses of postmortem examination so as to determine meticulous linkage in cause-result relation of traumatic cases

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