他伤并自伤致颅脑损伤法医学鉴定1例  

Forensic Clinical Evaluation of Complex Craniocerebral Injury Caused by Intentional Injuries and Self-infl icted Injury:A Case Repart

作　　者：宋健文[1] 徐彦昊 吕伟平 罗斌[3] SONG Jianwen;XU Yanhao;LÜWeiping;LUO Bin(Guangdong Justice Police Vocational College,Guangzhou 510520,China;Xinxing Public Security Bureau,Xinxing 527400,Guangdong,China;Sun Yat-sen University Forensic Identifi cation Center,Guangzhou 510500,China)

机构地区：[1]广东司法警官职业学院,广州510520 [2]广东省云浮市新兴县公安局,广东新兴527400 [3]中山大学法医鉴定中心,广州510500

出　　处：《刑事技术》2023年第5期543-546,共4页Forensic Science and Technology

基　　金：广东省科技创新战略专项资金项目“攀登计划”(PDJH2023b0893);广东省刑事技术“双十计划”(2022GDSSGG05)。

摘　　要：被鉴定人(男,39岁)被他人用拳头打伤头部、胸部、腹部等处,随后其头部被多次重撞到墙壁及床架上。期间,被鉴定人曾用玻璃酒瓶打击自己右侧头部2次。外伤后突发抽搐、昏迷,入院诊断为左额颞顶硬膜下血肿、蛛网膜下腔出血、脑疝和头皮挫伤。入院后经急诊行左额颞顶部硬膜下血肿清除加去骨瓣减压加脑膜修补术等治疗,术中发现硬膜下范围约12 cm×13 cm暗红色凝血块、左颞叶脑组织挫裂伤等。术后处于昏迷状态,长达8月余。本文围绕颅脑损伤发生的机制、他伤与自伤参与度、持续性植物状态的认定以及损伤程度鉴定等方面进行分析。A 39 year old male victim was injured in the head,chest and abdomen by fi st.Afterwards,his head was heavily hit against the wall and bed frame several times.During that time,he hit his right temples twice using a glass-made wine bottle.Then,he suddenly twitched and became unconscious.He was diagnosed with left frontotemporal parietal subdural hematoma,subarachnoid hemorrhage,cerebral hernia formation,and scalp contusion.The victim did not drink alcohol.After admission,an operation of removing bone flap decompression was performed to remove the left frontotemporal top subdural hematoma and repair the meninges.During the operation,dark red clot in the subdural area was found with the size of about 12 cm×13 cm,accompanying with contusion and laceration of left temporal lobe brain tissue.The victim remained in a coma for over 8 months after surgery.This article analyzes the mechanism of brain injury,the degree of participation of self-injury and intentional injuries,the identifi cation of persistent vegetative state,and the evaluation of injury severity.

关 键 词：颅脑损伤 参与度 自伤 持续性植物状态 

分 类 号：D919.4[医药卫生—法医学]