(ICH = intracerebral haemorrhage; VH = ventricular haemorrhage; EDH = extradural haemorrhage; SDH = subdural haemorrhage
; SAH = sub-arachnoid haemorrhage.) Depressed space 12% Contusion 13% ICH 3% VH 1% EDH 7% SDH 2% SAH 10% Free air 3% Others 49% Note: Table made from pie chart.
"I have no doubt that his subdural haemorrhage
has been caused by a fall - whether it has been by epileptic seizure, which on balance is more likely than not, or a fall because he was possibly intoxicated, is irrelevant.
During the specified period, 10 patients on acetylsalicylic acid with the following conditions were enrolled: intracerebral haemorrhage (N = 3), cerebral infarctions (N = 2), traumatic brain injury with contusion or acute subdural haematoma (N = 2), spontaneous subarachnoid haemorrhage with hydrocephalus (N = 1), and chronic subdural haemorrhage
(N = 2).
A post-mortem found Mr Haigh had died from a subdural haemorrhage
sustained in a fall.
Khajuria et al also noticed the similar findings; Subdural Haemorrhage
79.31%, Subarachnoid Haemorrhage 63.33%, Extradural Haemorrhage 48.85%, Intra-cranial injuries 21.26%, and Contusion 35.63% of the victims.
He said Dennis either had "a simple fall or a heart attack, brought on by the shock of seeing Nancy collapsed", which saw him hit his head, giving him a subdural haemorrhage
- killing him.
Mr Robertson went on: "As regards these fatal injuries inside the head, what is your response to the suggestion that all those injuries, the subdural haemorrhage
and bleeding, the neuro damage - could it be caused by a fall to the ground?" Dr Hamilton said: "A simple fall, even an accelerated fall, doesn't explain all of the injuries."
Non-accidental head injury (NAHI) occurs in approximately 12% of cases of physical abuse in children.(2) In the absence of significant trauma, a skull fracture in an infant, as in our patient, suggests a higher likelihood of NAI.(3) Subdural haemorrhage
(SDH) and subarachnoid haemorrhage (SAH) are common abusive injuries.(2) Shaking of the infant results in angular acceleration and deceleration shear forces that may tear the cortical bridging veins, resulting in SAH or SDH.(4) SAH may also occur from direct contact forces which cause tearing of vessels.(2)
The cause of death was a subdural haemorrhage
consistent with a fall, but the coroner recorded an open verdict as there was no explanation to how it happened.
Instead he suffered internal bleeding, and the extent of his injury was only discovered later that day, when doctors found he had a subdural haemorrhage
A CT brain scan showed a right frontal intracerebral haemorrhage with some associated mass effect, but no midline shift and a small left occipital subdural haemorrhage
A post mortem found he died of an acute subdural haemorrhage
caused by a cattle accident.