Background: Traumatic acute subdural haematoma (ASDH) remains one of the most fatal of all head injuries. Its fatality is governed by various factors. Materials and Method: Study of 101 cases of head injuries having a subdural hematoma with a definite history of trauma were carried during Sept 2011 to Aug 2013 in central morgue, SCB Medical College, Cuttack. Criteria examined were age, sex, volume, site, size, extension, form and character of ASDH. Results: The volume of fatal ASDH ranged from 15- 220 ml, having a male preponderance, with a highest peak of mean volume of 104.83 ml observed in between 71- 80 years of age. It is mostly attributed to road traffic accident (RTA) (86.87%), involving mostly frontal areas, usually fluid, blood in form, diffuse and frequently associated with subarachnoid haemorrhage (24.75%). Conclusion: Subdural haemorrhage has been always of a major significance in the absence of injury to the skull and brain. The haemorrhage in its form, location and amount is a determinant factor for the fatality. By post mortem evaluation of such haemorrhage in detail throws vital clues and information to the physician and surgeons to prevent such catastrophe in future patients.

Keywords: Acute subdural haematoma; RTA; Traumatic head injury.