Micromorphological criteria of the early periods in craniocerebral trauma]

System of quantitative criteria for early periods of craniocerebral trauma involving short intervals (0-5 min, 0.5h, 1-2h, 3-4h, 5-6h) was developed on the basis of micromorphometric study of the brain obtained from 120 persons who died of craniocerebral trauma. High informative value of morphometric characteristics of vagus dorsal nucleus (values of neurocyte quantity, disorientation and deformity; percentage of cells without visible changes and different pathomorphologic types; excess coefficient; coefficient of correlation between volumes of neuron bodies and nuclei; nucleus volume) was determined. Optimal conditions of using quantitative criteria were outlined.     

The forensic medical determination of the time of occurrence of subdural hemorrhages in the acute period of fatal craniocerebral trauma]

Presents the results of spectrophotometric and histologic examinations of subdural bleedings, meninges and brain matter in the acute period of a lethal craniocerebral injury. Discusses the possible use of a complex of histologic and biochemical studies in determination of the period elapsed since the injury.     

Evaluation of disorders in the liquor circulation in craniocerebral trauma

The modern methods of complex examinations of the brain in craniocerebral trauma are addressed and the possibilities of the topographic-and-anatomic substantiation in the forensic-medical (expert) evaluation of traumatic lesions of liquor-circulation structural elements are elucidated in the paper. Morphometry data characterizing the dislocation manifestations are presented with respect to the dislocation intensity and severity.     

Structure of the hypothalamic nuclei in a severe craniocerebral trauma

Large- and small-cell hypothalamic nuclei from 30 males who died of craniocerebral trauma were studied. Number of neurons at different stages of neurosecretory process was calculated in the large cell nuclei (supraoptic and paraventricular nuclei). Mean volume of neuron karyon (MVNK) was estimated in all the nuclei as a neuron function index. It was found that the proportion of neurons at different stages of the neurosecretory cycle is changed in large cell nuclei. This points to impaired synthesis of neurosecretion. Significantly increased MVNK of the neurons of paraventricular, arcuate and posterior nuclei was detected. The above evidence demonstrates activation of humoral hypothalamic regulation of the endocrine and immune systems.     

The forensic medical assessment of the micromorphology of brain stem hemorrhages in craniocerebral trauma

Microscopic features of primary and secondary hemorrhages in the stem portion of the brain in craniocerebral injuries are described. Criteria of differential diagnosis between primary and secondary hemorrhages in the stem in subjects dead during 24 h after isolated and combined craniocerebral injuries are defined. The forensic medical significance of differential diagnosis of hemorrhages in the stem for the solution of many expert problems is evaluated.     

Forensic medical differential diagnosis of craniocerebral trauma in children

It is emphasized that history, complaints, a comprehensive neurological examination, craniography are not often sufficient for differentiation between brain concussion and mild brain contusion in children because of specific characteristics of craniocerebral trauma (CCT) in such patients. To make an adequate forensic medical diagnosis of CCT in children, it is necessary to take into consideration anatomophysiological peculiarities of a child, biomechanical conditions of the brain injury, to apply modern methods of neurovisualization (ultrasonography, computed and MR imaging), to follow up brain function with quantitative electroencephalography. Improvement of differential forensic-medical assessment of CCT severity in childhood should be made according to the principles of evidence-based medicine.     

Neurovisualization methods in diagnostics of consequences in light craniocerebral trauma

The purpose of the case study was to elucidate the frequency rate of pathological changes as registered by computer tomography (CT) and magnetic-resonance tomography (MRT) of the head in patients with chronic cerebral blood-circulation deficiency (CBD), functional disorders and vegetative nervous pathologies in presence (in their medical histories) of closed-type cranial trauma concomitant with concussion of the brain (CB) or without such trauma. A comparative analysis revealed a minor prevalence in the number of pathological changes in patients with CBD concomitant with CB. As for other nosological forms, the quantities of changes, expressed in percent, were virtually identical. A conclusion was made on the need to examine the patients of the discussed category by neurovisualization in the acute and remote periods of trauma.     

有限元方法在法医学颅脑损伤分析中的应用

有限元方法(finite element method,FEM)是一种与现代计算机技术相联系的计算应力分析方法,已逐渐被应用于生物力学领域仿真人体结构力学功能研究,尤其是在颅脑损伤研究中最为广泛和深入。本文综述了现有头部有限元模型的特点、材料属性的赋值以及颅脑损伤有限元模型在钝力击打、高坠、交通事故等鉴定中的应用情况,探讨FEM建模在法医学颅脑损伤预测中的优劣势及其应用价值。     

Forensic-medical assessment of pathomorphological changes in the myocardium in blunt chest trauma with an isolated heart contusion

A total of 37 autopsy cases were divided into two groups. Group 1 consisted of 17 victims who had died of closed blunt trauma of the chest with isolated heart contusion made by fists, feet in shoes. Group 2 (control) consisted of 20 cases of sudden death of ischemic heart disease because of atherosclerotic cardiosclerosis. Fragments of the heart containing endocardium were studied on the microscope JEIL-SM200 (Japan). Endocardium pathomorphology was represented by relief changes of the endocardium, structural arrangement of separate groups of muscular fibers above the endocardium surface, hemorrhages and blood clots, endotheliocyte desquamation, prelacerations, lacerations and destruction of the endocardium.     

颅脑损伤血浆降钙素基因相关肽含量变化及法医学意义

目的研究颅脑损伤患者血浆中降钙素基因相关肽（CGRP）水平变化,观察其与颅脑损伤之间的关系并探讨其在颅脑损伤中的作用。方法40例脑外伤患者,其中轻中型（GCS评分9～15分）、重型（GCS评分3～8分）各20例。采用酶联免疫法测定患者伤后第1、3、5、7d及25例体检健康的志愿者血浆中CGRP水平。结果颅脑损伤患者与正常对照组比较血浆中CGRP水平明显增高,除轻中度组第7d外,均有显著性差异（P〈0．05）;且重度组在3d内高于轻中度组,有显著性差异（P〈0．05）。结论颅脑损伤者CGRP水平增高,且因病情加重会进一步升高,但随时间的延长有下降趋势。     

A case of fatal hemorrhage in the cerebral ventricles following intravenous use of methamphetamine

We describe a case of massive hemorrhage in the cerebral ventricles, probably caused by methamphetamine abuse. A 44-year-old male was found dead in a prone position in a hotel room. Old and new injection marks were observed in his right cubital fossa. Petechiae were observed on the conjunctiva of his right eye, laryngeal mucosa, epicardium and under the capsule of the liver (to a slight or moderate degree). The brain, weighing 1.67 kg, was heavily edematous; the lateral and fourth ventricles were filled with hematomas. Subarachnoid, intracerebral hemorrhages were not observed. Cerebral vascular abnormalities were not evident. There were no remarkable changes in other organs, other than congestion. Gas chromatographic-mass spectrometric analysis of the urine disclosed the presence of methamphetamine and amphetamine. The concentration of methamphetamine within the femoral venous blood and intraventricular hematoma was 0.347 microg/ml and 0.189 microg/g, respectively. Amphetamine was not detected in either sample. Urine contained 3.15 microg/ml methamphetamine and 0.063 microg/ml amphetamine. These results indicate that intraventricular hemorrhage might have occurred shortly after intravenous self-administration of methamphetamine. Cerebral arterial spasm and hypertension resulting from the administration of methamphetamine might have resulted in intraventricular hemorrhage.     

The characteristics of gunshot and blast trauma in Moscow in 1997

Forensic medical, social, and criminological characteristics of 417 cases with gunshot and explosion injuries investigated at Bureau of Forensic Medical Expert Evaluations of Moscow in 1997 are presented. Public and social groups of victims and types of violent deaths are discussed.     

Histo-morphological findings at the chiasma opticum in cases of craniocerebral trauma (author's transl)]

36 cases with pituitary haemorrhages were found histologically in 52 cases of lethal craniocerebral trauma. Simultaneously we found primary and secondary traumatic changes of chiasma opticum in 10 cases. The genesis and significance of the results are discussed.