132例滑动性脑挫伤类型与受力机制、受力部位的探讨

Investigation in the types of gliding contusion of brain in 132 cases and on its mechanism with site of force

目的研究脑受力后在颅腔内滑动挫伤的类型与受力机制、受力部位的关系。方法按颅骨解剖部位划定受力部位,根据案情确定受力方式后,对132例滑动性脑挫伤的脑标本,经福尔马林固定后作冠状、矢状或连续切面,肉眼、镜下观察。结果滑动性脑挫伤按发生部位不同分3型:脑顶型,65例(49.24%);脑底型,38例(28.78%);混合型,29例(21.96%)。脑顶型多见于额顶部的加速性受力,脑底型多见于枕部的减速性受力,混合型多见于顶枕部的减速性受力。结论3种类型与头部的受力机制、受力部位有相应关系。

Objective To investigate the relationship between the type of gliding contusion and its mechanism with site of force. Methods The site undergoing contusion and ways of force are respectively determined by skull anatomy location and details of these cases. Then, the 132 specimens of brain, which have been fixed by formalin, are sliced in coronal section and sagittal section and stained with HE, observed under microscope. Results Gliding brain contusion could appeared at the top and bottom region of brain respectively. Top-injury type, were observed in 65 cases （49.24%） , base-injury type, were found in 38 cases （28.78%）. There were 29 cases （21.96%） in which contusion could be found at both top and base of brain, we called mixed type. We found that the injury area depend on the ways of force-act：the top-injury type mostly caused by the force on cupular part of pars zygomatica in acceleration, the base-injury type mainly caused by the force on occipitalia in deceleration and the mixed type caused by the force on the boundry of the calvaria and occipital in deceleration. Conclusion The type of gliding contusion is relevant with mechanism and site of force.