head injury

Approximately 1 million patients present to hospital each year in the UK with a head injury, 90% of whom have a ‘mild’ or ‘minor’ head injury, whilst 5% have a ‘moderate’ and 5% have a ‘severe’ head injury. (Kay and Teasdale 2001).

The National Institute of Clinical Excellence, however, note that this may be an under-estimate, and that 700,000 patients attend accident and emergency departments in England and Wales each year with a head injury, and that in England in 2000/2001 there were 112,978 hospital admissions for head injury, of whom 72% were male, and 30% were children under 15 years of age. (NICE 2003).

Death from head injury in the UK has an incidence of 6-10 per 100,000 population each year, equivalent to 0.2% of patients attending accident and emergency departments for their injury. The majority of these fatalities are associated with ‘moderate’ (Glasgow Coma 9-12) or ‘severe’ (GCS 8 or below).

Adelson (1974) notes that head injuries are of particular importance in forensic medicine because:

• the head is often targetted in assaults
• the head can easily be injured when a person is knocked or pushed to the ground, and
• the brain and its coverings are more vulnerable to a degree of trauma that would rarely be lethal if applied to other areas of the body.

Frontal contusions and brain swelling (CT scan)

Source: Wikipedia

assessing the severity of head injury - the Glasgow Coma Score/ Scale (GCS)

pinterest

Profile (detail) made in paper by Lisa Nilsson 2011

references

• Kay A and Teasdale G (2001), 'Head injury in the United Kingdom', World Journal of Surgery 25:1210-1220
• National Institute of Clinical Excellence (NICE) (2003), 'Head injury: triage, assessment, investigation and early management of head injury in infants, children and adults', https://guidance.nice.org.uk/CG4/guidance/pdf/English
• Adelson L (1974), 'The pathology of homicide', Charles C Thomas, Springfield USA (https://www.ccthomas.com/details.cfm?P_ISBN13=9780398030001)

revise your anatomy

lateral view of human skull (source: eskeletons)

Revise your anatomy of the head, brain, and skull with the help of anatomy resources on the web ..

• eskeletons (very clear photographs of much of the skeleton, labelled with attachments, and including movies)
• skull bones illustrations via Instant anatomy
• skull bone anatomy - interactive flash resource with quizzes
• skull base anatomy and pathology flash animation
• neuroanatomy - coronal slices with labelling option,  3D3D vascular models, and quizes (name the labelled structures in fixed brains)
• whole brain atlas (CT/ MRI sequences, with labels, and movie capability for each sequence) - MR sequence movie
• head and neck vasculature - table of structures, origins etc
• Brain with cerebral vasculature (3D interactive model)
• radiographic anatomy, including skull (wikiradiography)
• neuroanatomy - follow colour-coded structures through a series of coronal, axial, and sagittal neuroradiological views (headneckbrainspine.com)
• neuroanatomy and physiology 'virtual labs' (Stanford University)
• general anatomy photographs, descriptions, and animations (anatomyexpert.com)
• label the structures
  • undersurface of the brain
  • the meninges
  • the blood vessels supplying the brain
• AnatomyLab quizes
•  the human brain.info

skull anatomy ipad app - BoneBox

get this app at itunes

revise your skull anatomy - foramina and structures passing through them

neuroanatomy - introductory video

revise your neuroanatomy

blood supply to the brain

revise your anatomy - blood vessels on the base of the brain and brainstem

Source: Neuroanatomy @ the University of British Columbia (follow link for full size version)

• vascular territories in the brain (arterial and venous) (Radiology Assistant)
• atlas of cerebral vasculature (interactive 3D model) (cerefy.com)
• test yourself by labelling the blood vessels supplying the brain here and here
• test yourself by labelling the venous drainage of the brain

forensic neuropathology

forensic neuropathology and associated neurology

essential forensic neuropathology

Radiology and head injury