• Lauren Vrbanic, Ciara Hunt, Maeve Cooney, Josephine Heffernan, Andrea Walsh, Ciara Heaney, Sally Anne Collis, Rachel Howley, Conor Fearon, Michael Farrell, and Francesca Brett.
• School of Medicine, Trinity College Dublin, Dublin, Ireland.
• Ir J Med Sci. 2023 Oct 1; 192 (5): 238723902387-2390.

IntroductionA difficult question in autopsy practice is whether intracranial haemorrhage has resulted from or brought about a fall.Material And MethodsTo address this we undertook a retrospective study of all autopsy reports (N = 2126) complied over a 10 year period (2009-2018). Of 720 patients who underwent a comprehensive post mortem neuropathologic examination we found 226 patients who had a history of a fall.ResultsOf the 226 with a history of fall, 175 (79%) had an intracranial haemorrhage which was classified as truamatic (n = 134, 77%) or spontaneous (n = 41, 23%. Within the traumatic group, falls from a standing height (51%) were more common than falls involving stairs (31%) or falls from a height (12%). Cerebral contusional injury (51%) and subdural haemorrhage (45%) were the most common type of haemorrhage in the traumatic group. In the spontaneous haemorrhage group cerebral amyloid angiopathy (49%) was the commonest detected cause and was typically lobar in distribution).ConclusionWe are of the view that a comprehensive analysis of fatal falls with intracranial haemorrhage warrants a detailed neuropathologic examination as part of the overall death analysis.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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