道路交通事故颅脑损伤的法医学鉴定

目的　研究道路交通事故中颅脑损伤的类型、特点、主要并发症及其受伤人员的伤残评定。方法　 862例道路交通事故颅脑损伤的案例资料 ,按伤者受伤的不同部位、有无并发症、并发症的类型及伤残程度进行统计分析。结果　复合性颅脑损伤 2 76例 ,脑挫伤 192例 ,颅骨骨折 79例 ,颅内出血 91例 ,头皮外伤 2 2 4例 ;主要并发症为脑积水 ( 19例 ,2 2 0 % )、癫痫 ( 16例 ,1 86% )、偏瘫 ( 14例 ,1 62 % )、植物人状态 ( 12例 ,1 3 9% )。结论　道路交通事故中颅脑损伤 ,以头部复合性损伤最多见 ,严重的脑挫伤为最常见的损伤类型 ,并发症的诊断应掌握诊断标准 ,并注意与相关疾病鉴别。

Investigation forensic of the brain injury in the road traffic accidents

Objective To study the type, characteristics, common complications of the cranio-cerebral injury and assessment for the body impairment in victims involved in road traffic accidents. Method Data from 862 cases with cranio-cerebral injury in road traffic accidents were collected and were statistically analyzed according to injured body part, complication, the type of complications and the severity of injury. Results Compound cranio-cerebral injuries were sustained in 276 cases, brain contusion in 192 cases, skull fracture in 79 cases, intracranial hemorrhage in 91 cases, and scalp injury in 224 cases. The chief complications were identified as hydrocephalus (19,2.20%), epilepsy (l6,1.86%), hemiplegia (14, 1.62%), decerebrate cortical syndrome (12,1.39%). Conclusion Among the cranio-cerebral injuries sustained in the road traffic accidents, compound injury was the commonest insult, in which serious cerebral contusion was the major type of injury. The complications following cranio-cerebral injury should be diagnosed strictly according to the diagnostic standard and identification time, which should be differentiated from the other related diseases.