颅脑损伤死亡案例的法医病理学分析

目的探讨颅脑损伤（BI）死亡的法医病理学特点,以及继发性脑干损伤、并发症的发生与死亡之间的因果关系。方法从性别、年龄、致伤方式、损伤类型、生存时间、死亡原因等方面,对四川大学华西法医学鉴定中心1998年1月2008年12月127例BI死亡尸检案例进行回顾性统计研究分析。结果 127例法医病理学检案中,原发性BI死亡51例（40.2%）,继发性脑干损伤死亡61例（48.0%）,并发症死亡15例（11.8%）,其中伤后12h内死亡者直接死因均为严重原发性脑损伤,存活12h～1周者直接死因以继发性脑干损伤居多,生存时间超过1周者约半数死于并发症。结论在BI案例的死亡原因确定时,应在全面系统的病理学检验基础上,结合案情及临床资料进行综合分析。

Forensic Pathologic Analysis of Traumatic Brain Injury

Objective To explore the characteristics of forensic pathology in traumatic brain injury and the relationships between secondary brainstem damage,complications and the causes of death.Methods 127 cases were reviewed from gender,age,manner of injury,survival time and the direct causes of death from January 1998 to December 2008.Results Of the 127 cases,the key direct cause of death was secondary brainstem damage,followed by severe primarily brain injury and complications.For those who died within 12 hours after injury,the direct cause was severe primarily brain injury;for those who survived between 12 hours to one week,secondary brainstem damage was in the majority of the causes and for those who survive more than one week time,complication was an important cause.Conclusion In the cases of traumatic brain injury,we should take comprehensive and systematic examination of forensic pathology,and refer to clinical data at the same time to determine the direct cause of death.