Kunz G, Pedal I, Schmidt G
Institut für Rechtsmedizin, Universität Heidelberg.
Beitr Gerichtl Med. 1990;48:317-23.
A 20 year old woman with a severe head injury and rapidly increasing brain edema died 46 hours after the accident. There was clinical evidence of protracted shock and disseminated intravascular coagulation. The autopsy revealed a macro-embolization of brain tissue of the lungs with many central and intermediate lung artery branches occluded by cerebral tissue. Preconditions of the brain tissue embolism were a severe fracture of the skull including a traumatic rupture of the right sigmoid sinus, together with a local brain laceration and an extremely elevated intracranial pressure. Fibrin precipitations were prominent at the surfaces of the brain tissue emboli as well as in peripheral blood vessels of the lung; in the systemic circulation, intravascular coagulation was much less pronounced.
一名20岁女性因严重头部受伤，脑水肿迅速加重，在事故发生46小时后死亡。有持续性休克和弥散性血管内凝血的临床证据。尸检显示肺脑组织出现大量栓塞，许多肺中央和中间动脉分支被脑组织阻塞。脑组织栓塞的前提是颅骨严重骨折，包括右侧乙状窦外伤性破裂，同时伴有局部脑裂伤和颅内压极度升高。在脑组织栓子表面以及肺外周血管中，纤维蛋白沉淀明显；在体循环中，血管内凝血则不太明显。
