Updating the risk profile of fatal head trauma: an autopsy study with focus on age- and sex-dependent differences

  • Katharina Kronsbein
  • Bernd Karger
  • Jan Budczies
  • Heidi Pfeiffer
  • Daniel WittschieberEmail author
Original Article


Fatal head trauma (FHT) represents one of the most frequent causes of death diagnosed in forensic pathology. However, profound statistic autopsy data on FHT is still sparse. Therefore, the purpose of this study was to investigate the circumstances and injury patterns of FHT with particular focus on age and sex, and additionally, to describe a recent risk profile of FHT. To this end, the forensic autopsy records of each FHT case at a large German university hospital during a 10-year period (2006–2015) were analyzed retrospectively (n = 372). The male-female ratio was 2.6:1. Regarding median age, females were 12.5 years older than males. Traffic-associated FHT represents the major mechanism of death, followed by fall-associated FHT. While accident was the major manner of death and presented a similar distribution of age and sex, homicides were the only subgroup with a significantly lower ratio between males and females. Skull fractures occurred in 78.2% and intracranial hemorrhages in 80.6% of all cases. In summary and partly in contrast to clinical data on head trauma, FHT still occurs predominantly in male individuals under the age of 45 years, in the context of traffic accidents and affected by alcohol intake. Improvements in traffic security as well as continuing surveillance of the incidence of FHT by forensic autopsies are necessary to further reduce the incidence of FHT.


Fatal head trauma Traumatic brain injury Autopsy Retrospective analysis Medico-legal assessment 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was granted by the Ethics Committee of the Westfalen-Lippe Medical Council and the Westfalian Wilhelms University of Münster, reference number: 2017-679-f-S.

Informed consent

No informed consent was required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Legal MedicineUniversity Hospital Münster, Westfalian Wilhelms UniversityMünsterGermany
  2. 2.Institute of Pathology, Division of BiostatisticsUniversity Hospital Heidelberg, Ruprecht Karls UniversityHeidelbergGermany
  3. 3.Institute of Legal MedicineJena University Hospital, Friedrich Schiller UniversityJenaGermany

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