原发性脑干损伤出血形态及分布特征分析  

Morphology and distribution of hemorrhagic focuses of primary brain stem injury

作　　者：顾晓生 方超 邢庭 施建松[2] 周盛斌[2] 窦国宴[2] 

机构地区：[1]江苏省人民检察院司法鉴定中心,江苏南京210024 [2]江苏省公安厅物证鉴定中心,江苏南京210024

出　　处：《中国法医学杂志》2014年第1期47-49,I0002,共4页Chinese Journal of Forensic Medicine

摘　　要：目的观察分析原发性脑干损伤出血灶的形态及分布特征,为法医学鉴定提供依据。方法选取34例原发性脑干损伤出血案例,常规制作病理切片,采用HE染色观察出血灶的形态及位置分布特征,并统计两者之间关系。结果原发性脑干损伤出血形态以裂隙样出血多见(61.6%)。出血灶位置分布组间比较显示,不同纤维走行和组织密度交界处、动脉周围、神经根等处以裂隙样出血多见(P<0.005);室管膜下主要表现为灶性出血(P<0.001);神经核团内出血较少,且裂隙样出血、灶性出血比例较为接近。结论不同纤维走行和组织密度交界处、动脉周围、神经根处的裂隙样出血是原发性脑干损伤的直接依据;神经核团内出血具有重要的法医学价值。Objective To investigate the morphology and distribution of hemorrhagic focuses of primary brain stem injury, and provide a basis for forensic identification. Methods The hemorrhagic focuses in 34cases with primary brain stem injury were observed and analyzed retrospectively to discover the potential relationship between morphology and distribution. Results The common hemorrhagic focuses were fissured hemorrhages, accounting for 61.6%. With multiple comparisons, fissured hemorrhages at the junction of different physical characteristic organizations, surrounding region of arteries, and nerve roots were common （ P 〈0. 005）; most of injuries at subependymal region were presented as focal hemorrhages（P 〈 0. 001 ）; and the morphological difference of hemorrhages in the nerve nuclear groups was not obvious. Conclusion Fissured hemorrhages at the junction of different physical characteristic organizations, surrounding region of arteries, and nerve roots are the definite and steady diagnostic basis for primary brain stem injury; most of injuries at subependymal region are presented as focal hemorrhages; and hemorrhages in the nerve nuclear groups have great medicolegal value.

关 键 词：法医病理学 原发性脑干损伤 出血灶形态及分布 

分 类 号：D919[医药卫生—法医学]