法医学杂志 ›› 2021, Vol. 37 ›› Issue (2): 206-210,216.DOI: 10.12116/j.issn.1004-5619.2020.400331

• 案例分析 • 上一篇    下一篇

11例创伤性颈内动脉颅内段破裂的回顾性分析

杜宇1, 张振宇1, 邱阳1, 贾琼1, 王伟东1, 庞俐1,2, 张金建1   

  1. 1. 中国刑事警察学院法医学系,辽宁 沈阳 110035; 2. 滁州市公安局刑事侦查大队,安徽 滁州 239000
  • 收稿日期:2020-03-30 发布日期:2021-04-25 出版日期:2021-04-28
  • 作者简介:杜宇(1977—),男,博士,副教授,硕士研究生导师,主要从事法医病理学教学、科研和鉴定;E-mail:gglovecb@163.com
  • 基金资助:
    公安部技术研究计划资助项目(2017JSYJC06)

Retrospective Analysis on Traumatic Rupture of Intracranial Internal Carotid Artery in 11 Cases

DU Yu1, ZHANG Zhen-yu1, QIU Yang1, JIA Qiong1, WANG Wei-dong1, PANG Li1,2, ZHANG Jin-jian1   

  1. 1. Department of Forensic Medicine, Criminal Investigation Police University of China, Shenyang 110035, China; 2. Department of Criminal Investigation, Chuzhou Public Security Bureau, Chuzhou 239000, Anhui Province, China
  • Received:2020-03-30 Online:2021-04-25 Published:2021-04-28

摘要: 目的 回顾性分析创伤性颈内动脉颅内段破裂的损伤特点,为法医学检验与鉴定提供参考。 方法 收集11例创伤性颈内动脉颅内段破裂的尸体检验案例,记录并统计死者的性别、年龄、致伤原因、现场失血情况、颈内动脉颅内段破裂部位、破裂处管壁硬化程度、颅脑损伤、血乙醇含量以及死亡原因等信息。 结果 11例均为现场死亡,其中交通伤7例,高坠伤和徒手伤各2例。11例死者头部体表损伤均不严重。9例交通伤和高坠伤死者颈内动脉颅内段破裂均发生于海绵窦段,均存在累及颈动脉沟的颅中窝横行骨折,颅内出血及脑挫伤轻微。2例徒手伤死者颈内动脉颅内段破裂发生在眼动脉段,均存在致死性的颅内出血及弥漫性轴索损伤而不伴有颅骨骨折。11例均为血管壁全层破裂,破裂口长轴与血管长轴垂直。 结论 交通、高坠等高能量创伤事件中,颈内动脉颅内段破裂的发生率值得关注。海绵窦段和眼动脉段的损伤可能较常见。血管遭受牵拉或碎骨片作用可能是颈内动脉颅内段破裂的主要损伤机制。

关键词: 法医病理学;创伤和损伤;颈内动脉;事故, 交通;高坠伤;徒手伤;案例分析

Abstract: Objective To retrospectively analyze the characteristics of the traumatic rupture of intracranial internal carotid artery in order to provide reference for forensic expertise examination and identification. Methods A total of 11 autopsy cases of traumatic rupture of intracranial internal carotid artery were collected. The gender, age, cause of injury, blood loss on the scene, location of internal carotid artery rupture, hardening degree of the rupture of the wall, brain injury, blood ethanol content and cause of death were also recorded. Results All 11 cases died on the scene, of which 7 died from traffic accidents, 2 falls from height and 2 from bare handed injuries. None of the 11 victims suffered serious head and body surface injury. The internal carotid artery rupture in the 9 cases of traffic injury and fall from height injury occurred in the cavernous segment. In all these cases, there were transverse fractures of the middle cranial fossa with the carotid sulcus involved, and minor intracranial hemorrhage and brain contusion. In 2 cases of bare handed injuries, internal carotid artery rupture occurred in the ophthalmic artery segment, accompanied by fatal intracranial hemorrhage and diffuse axonal injury, but no skull fracture. All 11 cases showed full-thickness rupture of the vessel wall, and the long axis of the wounds was perpendicular to those of the artery. Conclusion The incidence of intracranial internal carotid artery rupture in high-energy trauma events such as traffic accidents and high falls deserves attention. Injuries of the cavernous segment or ophthalmic segment might be more common. The main injury mechanism of intracranial internal carotid artery rupture might be that the blood vessels were pulled and the bone fragments caused damage.

Key words: forensic pathology, wounds and injuries, internal carotid artery, accidents, traffic, injury caused by fall from height, bare handed injury, cases analysis

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