Forensic Medical Approach to Non-traumatic (Pathological) Intracranial Haemorrhage Cases

Abstract

Objective: Pathological deaths are an important part of forensic autopsies. This study's objective was to assess, from a forensic perspective, non-traumatic (pathological) cases of intracranial haemorrhage, which hold a significant place among these types of deaths.

Methods: This study retrospectively evaluated 252 cases where autopsies conducted in the relevant institution's morgue department between January 1, 2013, and December 31, 2017, identified non-traumatic intracranial haemorrhage as the cause of death.

Results: 73.4% of the 252 patients were male. It was observed that 52% of the cases were in the 5th and 6th decade. 52% had new traumatic findings such as ecchymosis, abrasion, laceration, while 33% had no traumatic findings or artifacts. 42.1% had subarachnoid haemorrhage, 19% had parenchymal haemorrhage, 37.7% had subarachnoid and parenchymal haemorrhage, and 1.2% had subdural haemorrhage only. Of the 100 cases of intracranial haemorrhage caused by aneurysm, 83 were subarachnoid haemorrhage, 16 were subarachnoid and parenchymal haemorrhage, and 1 was parenchymal haemorrhage. The medial cerebral artery and its bifurcation had the highest rate of aneurysms (37%). Drugs or stimulants were found in 15 patients, and 7 patients had blood ethanol levels higher than 100 mg/dL.

Conclusion: Some cases in the study, many underlying factors leading to death were identified, such as alcohol use, drug use, cardiac findings, and infection, and it was concluded that the cause and origin of death could be determined with a well conducted forensic investigation, clinical findings of the deceased, and autopsy.