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Abstract

BSTRACT: INTRODUCTION: Intracerebral hemorrhage may be pathological or traumatic in nature. It may be primary or secondary BACKGROUND: Traumatic intracerebral hemorrhage (TICH) is a subtype of intracranial hemorrhage that occurs within the brain tissue itself and lead to displacement or destruction of brain tissue with high rate. Spontaneous intracerebral hemorrhage (SICH) is defined as a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. OBJECTIVE: The aim of this study is to determine the frequency of fatal traumatic and spontaneous intracerebral hemorrhage, and to differentiate between them in postmortem examination. METHODS: This cross-sectional study is performed in the medico-legal institute of Baghdad for (6) months duration from (1-10-2011) to (1-4-2012). Complete medico-legal history was obtained, and full proper autopsy including external and internal examination of all corpuses was performed specially the head. RESULTS: The study included (38) cases of intracerebral hemorrhage; (27) of them were (TICH). Their ages ranged between (5 –65) years, and (11) of them were (SICH) with an age ranging between (15 –75) years. Traumatic group was associated with male preponderance and younger age, while spontaneous group were females and older age. The most common cause of head injuries in the traumatic group was "missiles" followed by road traffic accidents. Comminuted fractures were the most common type of skull fracture. Brain laceration and contusion were the two most frequently observed associated lesions in the traumatic cases. The "intraventricular" Site was the most frequent in traumatic group, while the "Basal ganglia" was the most frequent in the spontaneous group. The anterior cerebral artery was the most frequently affected artery in traumatic group, while the middle cerebral artery was the most frequently affected artery in spontaneous group. CONCLUSION: we identified seven basic rules that can be used during autopsy examination in all cases of intracerebral hemorrhage to differentiate easily between traumatic and spontaneous intracerebral hemorrhage

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