J Clin Pathol 1986;39:1217-1220 Necropsy study of mountaineering accidents in Scotland

SUMMARY One hundred and twenty one people died in mountaineering accidents in Scotland between July 1978 and December 1983. Necropsies were carried out on 42, which form the basis of this report. In 21 cases head injury was a major fatality factor, but in 11 of these there were also serious chest injuries. Focal brain damage (haematomas, contusions, or lacerations) was more common (n = 21) than diffuse brain damage (n = 18). Over half of the victims with severe head injury had few other injuries and would probably have survived had the head injury been prevented. Spinal injuries usually occurred with other major injuries. Chest injuries were common, being serious in 18 cases, but abdominal injuries were uncommon. Four climbers with only minor injuries died of hypothermia. Mountaineering is a dangerous sport. There is, how-ever, little published information on the causes of death. Anecdotal reports from alpine countries have dealt with specific problems such as the exclusion of foul play, ' the prevalence of pre-existing disease,2 or the effects of suspension by rope.34 In the United Kingdom a brief summary of six negative necropsies was included in a report on accidental hypothermia.5 There seems not to have been a systematic necropsy study of mountaineering accident victims. In Scotland each year there are between 20 and 30 mountaineering deaths. Although all are investigated by the procurator fiscal (a senior legal official in Scot-land whose duties include directing the investigation of any sudden death), death in many cases is ascribed to "multiple injuries", and a necropsy is not done routinely. To obtain more detailed information nec-ropsies, including neuropathological examination, were performed on as many cases as possible over five and a half years