自发性蛛网膜下腔出血案例的法医病理学研究

Spontaneous Subarachnoid Hemorrhage:A Forensic Pathological Study of 46 Cases

目的 研究自发性蛛网膜下腔出血的病因病理、法医鉴定要点。方法 对本院鉴定的 46例蛛网膜下腔出血案例进行回顾性分析。结果 在本组蛛网膜下腔出血致死的案例中 ,40岁以下年龄段以脑动静脉畸形血管破裂为主要原因 ,且以动静脉畸形多见。 40岁以上年龄段 ,动脉粥样硬化血管破裂为第 1位原因 ,破裂处为大脑中动脉的豆纹动脉、脉络丛后动脉。动脉瘤破裂在本组案例中所占比例相对较小。结论 脑动静脉畸形血管破裂在自发性蛛网膜下腔出血致死案例中占较大比例。

Objective To explore the pathogenesis and key points of forensic identification in cases of spontaneous subarachnoid hemorrhage.Methods A retrospective review was made of the 46 cases of subarachnoid hemorrhage identified in Wannan Medical College. Results In all the deaths related to subarachnoid hemorrhage , the main cause for the cases under 40 years of age was angiorrhexis mostly due to the malformation of the cerebral arteries or veins, while for the cases aged 40 years or more, angiorrhexis relating to atherosclerosis was found to be the primary cause , with ruptures occurring in striate arteries and posterior choroidal arteries. The ruptured aneurysm account for a comparatively smaller proportion. Conclusion Vascular rupture due to the malformation of the cerebral arteries and viens account for a larger proportion in the death cases resulting from spontaneous subarachnoid hemorrhage.