dating of subdural haematoma

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Microscopic study of the organization of the Subdural Haemorrhage SDH verified against the time period can help us in the determination of its age which has serious medico-legal implications. Very few studies concerning the dating of SDH are present in the dating of subdural haematoma. This study was conducted for dating the early subdural haemorrhage by routine histopathological stains. A prospective analytical study was conducted during July to December A total of cases 50 males and 50 females fulfilling the inclusion and exclusion criteria were included in this study. Routine histopathological staining of the subdural haematoma was done. Correlation between the frequency of a given histomorphological phenomenon and the length of the Post-Traumatic Interval PTI was evidential. All the histomorphological features, when correlated with PTI groups, were found to be statistically significant, except for Polymorphonuclear Leukocytes PMN.

In the neonate, infant, or young child who has suffered from non-accidental injury, abusive head trauma AHT is acknowledged as the most common cause of fatality and long term morbidity with approximately 1, fatalities and 18, seriously disabled infants and children annually in the USA. Beyond the tragedy of an injured or murdered child is the broader social and community impact of this national and international health blight. In addition to the emotional, family, and social costs caused by inflicted trauma, the dating of subdural haematoma financial burden is astounding. Subdural hemorrhage SDH is the most common pathology associated with abusive head trauma. Hemorrhage in this location conforms to the classic morphology of subdural bleeding concavoconvex.

Determination of post-traumatic interval remains one of the foremost important goals of any forensic investigation related dating of subdural haematoma human crimes. The estimation of time since injury in cases of subdural haemorrhage has been studied only by a few investigators on the histological and radiological front. The study included a total of cases of closed head injury with subdural haemorrhage. Statistically significant results were obtained between the HU measurements of the SDH and the post-traumatic intervals and were found to be statistically significant.
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A subdural hematoma SDH is a type of hematoma —usually associated with traumatic brain injury —in which blood gathers between the inner layer of the dura mater and the arachnoid mater. It usually results from tears in bridging veins that cross the subdural space. Dating of subdural haematoma hematomas may cause an increase in intracranial pressure ICPwhich in turn can cause compression of and damage to delicate brain tissue. Acute subdural hematomas are often life-threatening. Chronic subdural hematomas have a better prognosis if properly managed. In contrast, epidural hematomas are usually caused by tears in arteriesresulting in a build-up of blood between the dura mater and the skull. The third type of brain hemorrhage, subarachnoid hemorrhagecauses bleeding into the subarachnoid space between the arachnoid mater and the pia mater. Symptoms of subdural hematomas have a slower onset than those of epidural hematomas because the lower-pressure veins involved bleed more slowly than arteries.

SDH can happen dating of subdural haematoma any age group, is mainly due to head trauma and CT scans are usually sufficient to make the diagnosis. Prognosis varies widely depending on the size and chronicity of the hemorrhage. Acute subdural hemorrhages usually present in the setting of head trauma. This is especially the case in young patients, where they commonly co-exist with cerebral contusions. Occasionally spontaneous acute subdural hematomas are seen with an underlying bleeding disorder e. A history of head trauma is often absent or very minor. Subdural hemorrhages are believed to be due to stretching and tearing of bridging cortical veins as they cross the subdural space to drain into an adjacent dural sinus.

While undergoing CT, the patient suddenly decompensated and became more obtunded, though still dating of subdural haematoma. He began to vomit and became incontinent of urine. CT of the cervical spine revealed no acute pathology. CT imaging of the brain revealed an acute 1. The right lateral ventricle and third ventricle were effaced see Figure 1. No masses were present, and there was no sign of epidural hematoma or subarachnoid hemorrhage. Neurosurgery staff arrived and repeated the physical examination.
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