الفهرس 
English Protocol
ANATOMY OF THE HEADOnly 14 pages are availabe for public view
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Abstract
Traumatic head injuries constitute a significant proportion of cases requiring forensic examination. It is considered one of the most common causes of homicidal deaths worldwide. This study aimed to: Analyze the demographic data of victims with fatal head injuries. Analyze the pattern of fatal head injuries and its forensic evaluation. Record some patterns, shapes and causes of fatal head injuries. This study included victims of fatal head injuries, which were autopsied at Qena governorate over a period of five years from the 1st of January 2011 to 31st December 2015. Data were collected from autopsy reports in Qena forensic department of ministry of justice archives. The present study included 149 victims. The majority 130 cases (87.2%) were males while only 19 victims (12.8%) were females. There was non-significant difference among males and females mean age (38.4 years ± 17.7 vs. 38.4 years ± 21.4; P= 0.99). Manner of death was homicidal in the majority of cases (99 cases) which represented 66.4% of all victims, the mean age was higher in victims died homicidally (42.1 years ± 18.1). Among the homicidal cases 85 cases were male victims and 14 cases were females. Also, the highest number of autopsied head injuries occurred in Dishna division (39 cases) followed by Nag Hammadi (37 cases), Qena (17 cases) and the least number of cases was found in Naqada (0 cases). The overall incidence of head injuries in Qena governorate was 4.7 per 100000 inhabitants where Dishna division had the highest incidence (10/100000 inhabitants) followed by Qena (7.2/100000 inhabitants), and the least incidence of head injuries in Qena governorate was noticed in Abu Tesht division (2/100000 inhabitants) and Naqada division (0/100000). A large number of autopsied head injuries occurred at year 2014 (37 cases) followed by year 2012 (33 cases), while the least number of cases was in 2011(25 cases). The highest number of autopsied head injuries occurred in summer (45 cases) followed by spring (42 cases), while the least number was noticed in winter (25 cases). May and July (22 cases for each) were the most frequent months of autopsied injuries followed by August and October (15 cases for each), while the least number of autopsied head injuries was noticed at January and December (7 cases for each). The most common causative instrument among the examined cases was the assault rifle (95 cases) followed by shomma and hand gun (14 cases for each), while the least was fall from height (2 cases). Victims, which were injured by sword/ axe had a mean age of 55.7 ± 19.8 years followed by iron pipe (55 ± 11.9 years) and shomma (51 ± 18.3 years). Least mean age was noticed within autopsied head injuries due to hand gun (26.4 ± 13.9 years). All victims with Shomma, iron pipe, sword/axe and motor car accident autopsied head injuries were injured homicidally. Also, homicidal death was noticed with majority of assault rifle (65.3%), injury with rock (66.7%). While, accidental manner of death had occurred among ten hand gun head injury victims. Also, it was noticed that all suicidal deaths were due to hand gun. The majority of victims 107 cases (71.8%) died immediately after head injuries, 20 cases (13.4%) died within hours and 17 cases (11.4%) died within days. Bone fractures were demonstrated in all studied victims, where the most common site of fracture was fracture of parietal bone found in 119 cases (80%) followed by base fracture in 90 cases (60%). While, the least fracture was jaw fracture in 26 cases (17%).The most frequent site of injury was in the front that occurred in 73 victims (49%) followed by the left side (24.2%), right side (17.4%), while the site of injury was in the back and above in (14.8%) for each. Brain hemorrhages were found in all the studied victims, where more than one type of hemorrhage occurred in the same victim in some cases, the most frequent form of brain hemorrhage was subarachnoid hemorrhage as noticed in 141cases (94.6%). It was noticed that epidural and cerebral hemorrhage were absent in case of fall from height. One hundred and five cases (98.1%) out of 141 cases associated with subarachnoid hemorrhage and 101 cases (94.4%) out of 122 cases of cerebral hemorrhage died immediately. While of those died within hours (20 cases), subarachnoid and cerebral hemorrhage occurred in 18 cases (90%) and 13 cases (65%), respectively. In those who died within days (17 cases), subarachnoid and cerebral hemorrhage also occurred in 13 (76.5%) and 4 (23.5%) victims respectively. Contusions and lacerations were frequently presented in 138 victims (92.6%) and 115 victims (77.2%) respectively. It was noticed that more than one type of injury occurs in the same victim. Death occurred immediately in most cases of brain laceration and contusion. Brain edema was found only in two victims, one of them died within hours and the other died within days.