Fatal injuries of the head and spine: epidemiological studies in New South Wales and South Australia.

In 1977, 1402 people died in New South Wales and 325 in South Australia from injuries to the brain or spinal cord. Records indicate that neurological injury is the leading cause of death in these States in the age range 0-44 years, accounting for more than 20% of deaths. A high proportion (41%) of accidents causing neurological injury occurred in country areas. We considered factors contributing to preventable causes of death. We found evidence of excessive consumption of alcohol in one-third of those tested; however, this estimation was omitted in many cases in both States. In the SA series at least 6% of deaths showed features suggesting that the primary neurological injury was not lethal. Potentially lethal secondary complications, such as respiratory obstruction or intracranial bleeding, may be reduced by earlier and better first aid and by speedier neurosurgical consultation. There is a need for more complete coronial autopsy examinations in all cases of violent death, and for the application of standardised diagnostic criteria.