Parilov S L, Klevno V A
Sud Med Ekspert. 2008 Jan-Feb;51(1):47-52.
The new conception of mechanism and sequence of damages typical for labor trauma is presented: injury of ligaments of atlas and axis and anterior atlanto-occipital membrane, ruptures of synchondrosises of cranial bones because of vertebral column pressing on occipital bone; tears of dura mater of brain upon basilar impression in the area of focal spot; subarachnoid hemorrhage and intracerebral bleeding in case of cerebral compression by bone borders where they overly override; ruptures of ligaments of cervico-occipital and intervertebral joints in case of excess flexion and overextension of head. Authors show that damage of sutures, bones of calvarium and partition parts of dura materialize later than injury of synchondrosises of base and they are absent if sinchondrosises are not damaged. Also iatrogenic damages of fetal in labor and the mechanism of their formation are described.
寰椎和枢椎韧带及寰枕前膜损伤，因脊柱压迫枕骨导致颅骨软骨结合处破裂；在病灶部位基底凹陷时脑硬膜撕裂；在骨边缘过度覆盖导致脑受压的情况下蛛网膜下腔出血和脑内出血；头部过度屈曲和过度伸展时颈枕关节和椎间关节韧带断裂。作者表明，颅骨缝线、颅骨和硬脑膜分隔部分的损伤比基底软骨结合处损伤出现得晚，如果软骨结合处未受损则不会出现这些损伤。此外，还描述了分娩时胎儿的医源性损伤及其形成机制。
