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Fatal Head Injuries in Ground-Level Falls

1997; Lippincott Williams & Wilkins; Volume: 18; Issue: 3 Linguagem: Inglês

10.1097/00000433-199709000-00006

1533-404X

Nikolas J. Hartshorne, RC Harruff, Ellsworth C. Alvord,

Traumatic Brain Injury and Neurovascular Disturbances

We analyzed 75 cases of fatal ground-level falls that were investigated by the King County Medical Examiner over a 48-month period, with autopsies performed on 87% of the deaths: 69% of the cases were men and 61% occurred in ages ≥70 years; only 12% were aged <50 years, with the youngest aged 28 years. Most of the falls occurred in or about the residence, and many individuals were known to have fallen onto hard surfaces. In 77% of cases there was significant pre-existing natural disease, mostly cardiovascular disease. Liver disease was more frequently a contributing factor in those aged <50 years. Ethanol was present in 48% of those cases tested, more frequently present in men than in women. Basal skull fractures were present in 37% of cases, and acute subdural hematomas, the most common intracranial lesion, were present in 85%. We concluded that fatal ground-level falls were much more common in elderly persons, owing to a greater predisposition to falling, as well as intrinsic age-related changes, including a greater susceptibility to acute subdural hematoma.