Yanagida Y, Fujiwara S, Mizoi Y
Department of Legal Medicine, Kobe University School of Medicine, Japan.
Forensic Sci Int. 1989 Apr-May;41(1-2):135-45. doi: 10.1016/0379-0738(89)90245-4.
In cases of a severe head injury caused by a fall, coup contusions are either absent or very minor, in contrast to presence of extensive contre-coup damage. In cases of a severe blow to head, however, the reverse occurs, with contre-coup lesions a rarity and coup damage extensive. To investigate this further, head injuries caused by a 'blow' or a 'fall' have been studied, using physical human models of the head and neck, both filled with distilled, degassed water and fixed onto a dummy torso. An impact of a constant magnitude was applied to the midoccipital region in 'blow' and 'fall' experiments, and the acceleration of the head and changes in the intracranial pressure were measured, with the resulting data analyzed by a computer. In both experiments, the peak amplitude of the acceleration pulse were almost the same. Similarly, the intracranial pressure curve at the impact site consisted of a positive pulse that hardly differed, nor did the peak amplitude of that pulse vary significantly. In the 'blow' experiment, however, the intracranial pressure curve at the site opposite the impact consisted of a negative pulse, whereas in the 'fall' experiment, the intracranial pressure recorded at the same area was negative but of a longer duration, with an absolute value that was slightly greater. Our results indicate that an impact to the head triggers a different response in the intracranial space, dependent on whether that impact force was caused by a 'blow' or a 'fall'.
在因跌倒导致的严重头部损伤病例中，冲击伤要么不存在，要么非常轻微，与之形成对比的是广泛的对冲伤的存在。然而，在头部受到严重撞击的情况下，情况则相反，对冲性损伤罕见，而冲击伤广泛。为了进一步研究这一点，研究人员使用头部和颈部的人体物理模型（均充满蒸馏脱气水并固定在模拟躯干上），对由“撞击”或“跌倒”导致的头部损伤进行了研究。在“撞击”和“跌倒”实验中，对枕骨中部区域施加恒定大小的冲击力，并测量头部的加速度和颅内压的变化，所得数据由计算机进行分析。在两个实验中，加速度脉冲的峰值幅度几乎相同。同样，撞击部位的颅内压曲线由一个几乎没有差异的正脉冲组成，该脉冲的峰值幅度也没有显著变化。然而，在“撞击”实验中，撞击部位对面的颅内压曲线由一个负脉冲组成，而在“跌倒”实验中，在同一区域记录到的颅内压为负，但持续时间更长，绝对值略大。我们的结果表明，头部受到撞击时，颅内空间会引发不同的反应，这取决于撞击力是由“撞击”还是“跌倒”引起的。
