Aim: To determine
the frequency, pattern and location of brainstem injuries with histopathologic
analysis during postmortem examinations.
Study Design: Retrospective
Place and Duration of Study: Department of Forensic Medicine& Toxicology and Department of
Pathology, Peoples University of Medical & Health Sciences for Women,
Shaheed Benazirabad, Sindh from 1stJanuary 2014 to 31st December
Methodology: Eighty three cases
with head injury were reported, of them 48 had brain stem hemorrhage. Brain
autopsy was performed, and findings are reported.
mean age of patients was 57.12±6.24 years. Mid brain hemorrhage was found in
20(41.6%) patients while pontine hemorrhage was found in 10(20.8%) patients.
Eight (16.6%) patients had hemorrhage at medulla, 7(14.5%) patients had
hemorrhage at the ponto-medullary junction, while 3(6.2%) patients had
hemorrhage at cervico-medullary junction. The most common mode of injury was
road traffic accidents (n=23) followed by assault (n=14), blow to the neck
(n=9) and fall (n=2).
Conclusion: most common site for hemorrhage in brainstem was midbrain followed by
pons and medulla. Traumatic brainstem injuries are often associated with
lesions at other sites of brain and poor prognosis. The most common mode of
injury in our study was road traffic accidents.
Keywords: Brainstem injury, Trauma, Brainstem