Objective: Brain trauma and its burden is becoming a significant cause of permanent damage and deterioration. Prioritization at the place of the incident and calculation of mortality are leading factors for the final management, but all of them are obtained from living patients. When the autopsies are made there is no actual score system to guide the forensic scientists in their conclusions. Should all of the cadavers with traumatic brain injury (TBI) have been dead? Therefore, we aim to present a score system—brain trauma mortality score scale (BTMSS), aiming to evaluate postmortem the actual risk of mortality. Methods: We established a score scale, which could be used on cadavers for the evaluation of the events. Afterwards, we applied this score scale on the reports of the cadavers who suffered blunt force TBI for a 10-year period of time between 2007 and 2016. Thereafter, the results were processed with SPSS version 25. Results: The outcome showed that there is a significant difference between the scores of the cadavers who died at the place of the incident and those who died in hospital thus approving that the BTMSS works well, as well as the importance of level I trauma center. Conclusion Every score system could show something useful for the management of the TBIs. The solution and improvement in the outcome of the current study would be a level I trauma center with a qualified neurosurgical department.

OBJECTIVE: Penetrating brain trauma (PBT) caused by gunshot is one of the most lethal traumatic brain injuries (TBIs) and its management and confrontation is of great importance. METHODS: The authors searched retrospectively the archives from 2 similar autonomous laboratories of forensic science and toxicology in the Balkan peninsula for a 10-year period of time and included only fatal penetrating brain injuries. RESULTS: The study is conducted in 61 cadavers with gunshot PBT. All of the cadavers were victims of suicide attempt. The most common anatomical localization on the skull were the facial bones, followed by skull base, temporal and parietal bone, conducting a trajectory of the gunshot. Additional findings were atherosclerosis of the blood vessels and chronic diseases such as chronic obstructive pulmonary disease, cancer and fatty liver. CONCLUSION: PBI has a high mortality rate. There are factors and findings from the collected data differing between the 2 aforementioned nations. Either way, better preventative measures, gun control and healthcare system are highly necessary.
Atherosclerosis ; Balkan Peninsula ; Blood Vessels ; Brain Injuries ; Brain ; Bulgaria ; Cadaver ; Chronic Disease ; Delivery of Health Care ; Ethnic Groups ; Facial Bones ; Fatty Liver ; Forensic Sciences ; Greece ; Head Injuries, Penetrating ; Humans ; Mortality ; Parietal Bone ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Skull ; Skull Base ; Suicide ; Toxicology ; Wounds, Gunshot