100例重度颅脑损伤尸检分析

Analysis of autopsy of 100 cases with head injury

本文总结分析１００例重度颅脑损伤的尸检资料。年龄最小４个月，最长者７１岁，男性７０例，女性３０例。颅脑损伤成因以钝器伤、高坠伤、跌伤及交通事故为多。头皮损伤占８３％，头皮无明显损伤但有颅脑损伤者占１７％。颅骨骨折占７１％，以线状骨折为多（４５％），粉碎骨折次之（２２．５３％），颅骨骨折常合并颅内出血。两者并存者６９例，占颅内出血７０．４１％，有颅内出血无颅骨骨折２９例，占２９．５９％，略高于文献报告。硬膜外出血（ＥＤＨ）占３５％，冲击部占８８．５７％，对冲部占２０％。硬膜下出血（ＳＤＨ）占４０％，冲击部占８５％，对冲部占２５％。蛛网膜下腔出血占８７％。髓内出血８６％，合并ＥＤＨ占３３．７２％，合并ＳＤＨ占３６．０５％，ＥＤＨ、ＳＤＨ和髓内出血者同时发生占８．２６％。脑室出血占１２％。脑挫伤裂伤占６４％，有冲击伤和对冲伤占４６．８８％，有冲击伤无对冲伤占２８．１２％，无冲击伤有对冲伤占２５％。脑疝：小脑扁桃体疝占６７％，海马钩回疝占６０％，略高于文献报告，结合本文资料，对病理特点及法医鉴定中应注意问题略加讨论。

A series of 100 autopsies on cases with head injury was performed. The age of all the cases ranged from 4 months to 71 years, among which 70 were male and 30 were female. The most common causes of head injury were blunt injury, high falling injury, falling injury and traffic accident. The cases with scalp injury were 83% but the rest with cerebral injury were 17%. The cases with cranial fracture were 71%, in which fissured fracture or comminuted fracture were 45% or 22.53%. The cranial haemorrhage was frequently accompanied with cranial fracture (69 cases--70.41%), with out cranial fracture (29 cases-29.59% ). The cases with EDH was 35%, in which coup--injury was 88.57% and conter-coup injury 20%. The cases with SDH was 40% in which coup injury was 85% and conter-coup injury 25%. The cases with subarachnoid haemorrhage was 81%. The cases with intracranial haemorrhage was 86% in which accompaning EDH、SDH or EDH and SDH was 33.73%、36.05% or 8.26% respectively. The cases with cerebral contusion was 46% in which accompaning coup injury and conter--coup injury, only coup injury or only conter--coup injury was 46.88%、28.12% or 25% respectively. The cases of cerebella tonsillar hemia or trans--tentorial hemia was 67% or 60% of cases with intra--cerebral hemia separately. The autopsied finding is very useful in the forensic pathological application.