Forensic medical analysis of head injuries in drivers sustaining fatal in-vehicle trauma

BACKGROUND: One of the primary tasks of a forensic medical expert in examinations related to in-vehicle trauma is determining the mechanism of injury formation, its severity, and the position of the victim. This often requires addressing questions regarding the specific mechanisms of traumatic brain injury, its morphology, and its severity. AIM: To study the characteristics of head injuries sustained by drivers in fatal in-vehicle automobile trauma. MATERIALS AND METHODS: Expert reports from the Bureau of Forensic Medical Examination of the Moscow Department of Health from 2006 to 2013 were analyzed to assess the presence and localization of head injuries in drivers involved in road traffic accidents. The Injury Severity Score (ISS) was used to assess the severity of traumatic brain injuries in drivers of domestic and foreign-manufactured vehicles. RESULTS: The study found no significant differences between the comparison groups in the ISS score ranges of 0–10 and 11–20 points. However, in the ISS score ranges of 21–30 and 31–40 points, fatal injuries were more prevalent among drivers of domestic vehicles, while in the 41–50 point range, they were more common among drivers of foreign-manufactured vehicles. CONCLUSION: In cases of fatal traumatic brain injury, significant differences in injury localization and severity suggest the presence of additional factors that require further investigation and should be considered when determining the victim’s position in the vehicle at the time of the accident. © 2025 Elsevier B.V., All rights reserved.