Gunji Hirobumi, Mizusawa Ikubumi, Hiraiwa Kouichi
Department of Legal Medicine, Fukushima Medical University School of Medicine, Japan.
Leg Med (Tokyo). 2002 Jun;4(2):84-9. doi: 10.1016/s1344-6223(02)00012-3.
Autopsy records and photographs of traffic accident deaths from 1985 to 2000 as well as police reports were reviewed to determine the morbidity and pathological features of traumatic brainstem lesions and to determine the relationship between lesions and forces applied. Of 156 autopsied traffic accident cases, 26 (16.7%) of the victims had gross primary brainstem injury. The 26 victims included 19 pedestrians, five cyclists, one driver and one passenger. There were four cases of upper face impact and two cases of lower face impact in which the direct forces to the head had caused hyperextension of the neck. However, eight of the pedestrians and two of the cyclists had medullary lesions for which the cause could not be explained by the direct impact to the head, suggesting that indirect forces, i.e. the inertia of the head, had caused neck hyperextension at the moment of impact with the car. Based on the findings in this study, it was concluded that when a pedestrian or cyclist is hit by a vehicle travelling at high speed, the traction force due to the inertia of the head is one of the causes of violent hyperextension of the head that result in traumatic brainstem lesions.
回顾了1985年至2000年交通事故死亡者的尸检记录、照片以及警方报告，以确定创伤性脑干损伤的发病率和病理特征，并确定损伤与施加的外力之间的关系。在156例交通事故尸检病例中，26名（16.7%）受害者存在原发性脑干严重损伤。这26名受害者包括19名行人、5名骑自行车的人、1名司机和1名乘客。有4例面部上侧受撞击和2例面部下侧受撞击的情况，头部受到的直接外力导致了颈部过伸。然而，8名行人以及2名骑自行车的人存在延髓损伤，其损伤原因无法用头部直接撞击来解释，这表明间接外力，即头部的惯性，在与汽车碰撞瞬间导致了颈部过伸。基于本研究的结果，得出结论：当行人或骑自行车的人被高速行驶的车辆撞击时，头部惯性产生的牵引力是导致头部剧烈过伸并造成创伤性脑干损伤的原因之一。
