Autopsy case report of delayed intracranial hemorrhage following mild head trauma: clinical and legal perspectives.

BACKGROUND

Delayed intracranial hemorrhage (DICH) is a rare type of traumatic brain injury, described as the delayed presentation of hemorrhage on computed tomography or at autopsy several hours to weeks after traumatic events, despite a normal finding at the initial neuroimaging. It generally has a good prognosis, and operative management is seldom required.

CASE DESCRIPTION: We present the case of a 66-year-old male who died due to intracranial hemorrhage nearly two days after a traffic accident. According to the medical records, he was on anticoagulant therapy, and his wife reported that he had experienced nausea 24 hours after discharge. At autopsy, a left-sided subdural hematoma, subarachnoid hemorrhage, and contralateral hemorrhage in the pons were observed macroscopically, while diffuse axonal injury in the pontine parenchyma was identified microscopically. The cause of death was determined to be traumatic intracranial hemorrhage, and a causality was established between the traumatic incident and the fatal outcome.

CONCLUSIONS

This case report emphasizes that accurate causal evaluation of the condition requires recognizing its etiology, clinical manifestation, and risk factors, while underscoring the need for effective clinical strategies focused on patient and family education regarding warning symptoms and timely emergency presentation.