经神经病理学检查的法医尸检病例中原发性头部损伤的位置和累积情况,以及继发性损伤的发生率 - 一项关于跌倒和袭击的比较研究。

IF 2.2 3区 医学 Q1 MEDICINE, LEGAL
Teemu Silver , Petteri Oura
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引用次数: 0

摘要

尽管创伤性脑损伤(TBI)是全球死亡的主要原因之一,但有关原发性头部损伤的位置和累积情况,以及跌倒和袭击等不同损伤情况下继发性损伤发生率的详细数据却十分有限。本研究旨在突出经神经病理学检查的法医尸检病例中坠落伤和袭击伤在损伤模式上的差异。研究收集了2016年至2022年期间芬兰卫生与福利研究所法医组共128例病例的数据。所有病例均疑似或确诊为急性颅脑损伤,并接受了全面的神经病理学检查。背景和环境变量,以及是否存在头部和脑部损伤,均从医学法律尸检病例档案中提取。对放心摔倒(26 例)和袭击(23 例)进行了比较分析。在全部样本中,57.0%的病例出现了原发性头部损伤;最常见的原发性损伤是头皮出血(47.7%)、蛛网膜下腔出血(SAH)(24.2%)和弥漫性创伤性轴索损伤(13.3%)。与摔伤病例相比,袭击病例头皮出血(82.6% 对 46.2%,P = 0.016)和蛛网膜下腔出血(52.2% 对 11.5%,P = 0.004)的发生率明显更高。在袭击病例中,左半球明显比右半球更常受到影响(91.3% 对 65.2%)。在继发性损伤中,袭击造成的脑水肿比跌倒造成的脑水肿更常见(47.8% 对 7.7%,P = 0.003)。总之,本研究强调了跌倒与袭击之间头部和脑部损伤模式的差异。头皮出血和 SAH 在袭击中比跌倒更常见。袭击似乎导致更高频率和更多样化的伤害,尤其是在左半球。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Location and accumulation of primary head injuries, and prevalence of secondary injuries among neuropathologically examined medico-legal autopsy cases – A comparative study of falls and assaults
Even though traumatic brain injury (TBI) is a major cause of death globally, detailed data on the location and accumulation of primary head injuries, and prevalence of secondary injuries in distinct injury circumstances such as falls and assaults is limited. This study aimed to highlight the differences in injury patterns between falls and assaults among neuropathologically examined medico-legal autopsy cases. Data were collected on a total of 128 cases from the Forensic Medicine Unit, Finnish Institute for Health and Welfare, between the years 2016 and 2022. All cases had suspected or confirmed acute head injuries and underwent a full neuropathological examination. Background and circumstantial variables, as well as the presence of head and brain injuries, were extracted from the medico-legal autopsy case files. Comparative analyses were conducted between assured falls (n = 26) and assaults (n = 23). Any primary head injury was observed in 57.0 % of the full sample; the most common primary injuries were scalp haemorrhage (47.7 %), subarachnoid haemorrhage (SAH) (24.2 %), and diffuse traumatic axonal injury (13.3 %). Assault cases showed a significantly higher prevalence of scalp haemorrhage (82.6 % vs. 46.2 %, p = 0.016) and SAH (52.2 % vs. 11.5 %, p = 0.004) compared to fall cases. In assault cases, the left hemisphere was clearly more frequently affected than the right one (91.3 % vs. 65.2 %). Of secondary injuries, brain oedema was more common in assaults than falls (47.8 % vs. 7.7 %, p = 0.003). In conclusion, this study highlights differences in head and brain injury patterns between falls and assaults. Scalp haemorrhage and SAH are more common in assaults than falls. Assaults appear to lead to a higher frequency and diversity of injuries, particularly in the left hemisphere.
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来源期刊
Forensic science international
Forensic science international 医学-医学:法
CiteScore
5.00
自引率
9.10%
发文量
285
审稿时长
49 days
期刊介绍: Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law. The journal publishes: Case Reports Commentaries Letters to the Editor Original Research Papers (Regular Papers) Rapid Communications Review Articles Technical Notes.
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