11例脑皮质挫伤远区及脑干病变的光镜和扫描电镜观察报告

ANALYSIS OF 11 CASES DIED OF CEREBRAL TRAUMA

本文报告11例因脑外伤致死的案例。肉眼观察10例有轻重不等的大脑皮质挫伤；10例有蛛网膜下腔出血；3例有脑干出血；1例有视丘下部出血。光镜及扫描电镜下见大脑皮质挫伤10例；其余挫伤，在距大脑皮质挫伤3cm的脑白质6例，视丘下部8例，丘脑、中脑各6例，桥脑5例，延髓4例，侧脑室壁8例及视神经4例。镜下检查挫伤远较肉眼为多。10例神经细胞有不同程度变性、坏死及缺血性病变。9例大脑及脑干轴索、髓鞘有不同程度断裂、变性、排列紊乱、崩解及坏死，其中7例轴索断端查见收缩球。作者对脑外伤死因及法医学鉴定应注意的问题作了简要的讨论。

This paper reports 11 cases died of cerebral injuury. Grossly,various degree of cerebral contusions and subardchnoul hemorrhages were found in 10 cases, hemorrhags of brainstem in 3 cases and of hy-pohalamus in 1 case' Under light and scanning electron microscope, cerebral cortex contusions werefound in 10 cases, contusions and hemorrhages of white matter 3 cm far from the area of cerebral cortex contusbos in 6 cases, contusions of hypohalamus in 8 cases, of pons in 5 cases, of bulb in 4 cas-es, of lateral vertricular wall in 8 cases and of optic nerve in 4 cases. Degeneration, necrosis and is-chemical changes of nerve cells were found in 10 cases. Degeneration, disarrangement, breakage and necrosis of axon and myelin sheath in cerebrun and brainstems were Observed in 9 cases. In 7 out of 9cases, retfract balls of broken axons were seen. The causes of death of the cerebral trauma and the diffrential diagnosis were briefly discussed.