EVALUATION OF FORENSIC CASES ASSOCIATED WITH NEUROCHIRURGY ADMITTED TO EMERGENCY CLINIC

Introduction: Forensic cases consist of medical cases associated with several distinct medical departments, and meticulous examination and recording should be “sine qua non” part of the management. We aimed to analyze the files of forensic cases in neurochirurgy clinics, evaluate these files by the view of forensic medicine, and to emphasize the importance of meticulous medical recordings. Materials and Methods: Patients admitted to the neurosurgery clinic from the emergency department, motor vehicle accidents, motorcycle accidents, work accidents, hanging cases, assault or chemical injuries were included in the study. The electronic files, radiographs, computed tomography and magnetic resonance imaging recordings of the patients were analyzed and compared with patient cart. Age, gender, the causes of the events, and the number of autopsy were recorded. The patients were grouped according to gender, the admission ward (intensive care unit (ICU) or service), and the cause of the admission of the patient. Non-forensic cases; for example, patients with degenerative disc herniation, spontaneous cerebral hemorrhage or cerebral tumor were excluded. Results: A total of 275 patients with suitable criteria, were included in the study. Of total, 249 (90,54%) patients were in alive, 26 (9,46%) in exitus group. 12.9% and 7.7% of the patients were female in alive and exitus groups, respectively (p=0.753). All the patients in chemical injury, hanging and work accident groups were male. The ratio of admission to ICU was 99.6% and 100% in alive and exitus groups, respectively. The most frequent cause of admission was traffic accident in both groups; however, there was significant difference between groups according to cause of admission (p=0.002). When comparing to traffic accident group, the mortality rate was 6.2 times higher in motorcycle accident, and it was 6.8 times higher in hanging group. Conclusion: We found that the most frequent cause of admission was traffic accident both in alive and exitus groups. However, the mortality rate of hanging and motorcycle accident was higher than motor vehicle accident. This finding helps us to evaluate which forensic cases necessitate acute medical management in emergency ward. For the forensic cases concerning to neurochirurgy, the specialists of neurochirurgy should be in contact with the emergency clinic team. At the same time, we also believe that accurate medical records of forensic cases related to neurosurgery will contribute to the correct and rapid management of the judicial process