[Causes of and circumstances in death due to subdural hematoma].

This study concerns lethal subdural hematomas in the autopsy material at the Institute of Forensic Medicine of the University of Hamburg (n = 102; 0.9% of 11,462 autopsies 1980 to 1988). 63 fatalities were male (mean age 46 years) and 39 were female (mean age 53 years). Subdural hematomas were predominantly located parietotemporal (64%) and had an average volume of 125 ml. Rupture of the bridging veins and contusions of the cerebral cortex were frequent sources of bleeding. In one third of cases the exact topographical site of bleeding was not determined. 90% of the subdural hematomas were of traumatic origin, two thirds had an acute clinical course of less than twelve hours; 23 times neurosurgical intervention took place. With respect to the criminal and civil law it is of decisive significance to explain the causal relationship between subdural hematomas and preceding trauma. Recently there is an increase in blame against physicians in cases where the subdural hematoma (e. g. of inebriated persons) was not diagnosed and treated immediately.