title: Head injuries in falls from a standing height: do fractures of the orbital roof matter? A prospective autopsy study.
abstract: OBJECTIVE
  The aim of this study was to analyze the occurrence and characteristics of orbital roof fractures, periorbital hematoma, conjunctival hemorrhage, orbital roof discoloration, and concomitant head injuries in falls from a standing height.
  
  
  METHODS
  A prospective autopsy study was performed over a 4-year period (from 2010 to 2013). Subjects who had died due to traumatic brain injury caused by falls from a standing height were included in the study.
  
  
  RESULTS
  Fifty cases of ground level falls were recorded. This group consisted of 39 men and 11 women, with an average age of 67.3 ± 13.6 years, and median age of 70 years. Skull fractures originating in the proximity of impact site were found in 47 of 50 individuals, and 22 had isolated orbital roof fractures not connected to the fracture line. Bluish discoloration of the orbital roof was noted in 19 subjects, 14 had periorbital hematomas, and 12 had blotchy or purpura-like conjunctival hemorrhages.
  
  
  CONCLUSIONS
  Isolated orbital roof fractures in falls from a standing height are easily detected using a standard autopsy technique, with special regard to careful removal of the dura in the anterior cranial fossa. Our study shows that orbital roof fractures can occur in accidental falls from a standing height and may not be associated with concomitant skull fractures and brain injuries.
authors.affiliation: Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Živković
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolić
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001827:Body Height; D001930:Brain Injuries / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D002423:Cause of Death; D003229:Conjunctival Diseases / Q000401:mortality / Q000473:pathology; D005130:Eye Hemorrhage / Q000401:mortality / Q000473:pathology; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000293:injuries / Q000473:pathology*; D009917:Orbital Fractures / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000209:etiology / Q000401:mortality / Q000473:pathology*