Department of Medical Informatics and Biostatistics, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2020;61(1):95-103. doi: 10.47162/RJME.61.1.10.
Deaths caused by traumatic brain injury (TBI) increase in incidence every year worldwidely, mainly in developing countries. Thus, World Health Organization (WHO) estimates that in 2020, TBI will become the third main cause of death. In our study, we evaluated the deaths caused by TBI recorded within the Institute of Forensic Medicine of Craiova, Romania, between 2011 and 2017. Therefore, according to age, the cases were divided into two groups: people aged 0-18 years old (including 18 years old) and people aged over 18 years old (a total of 1005 cases, of which 971 were adults and 34 included in the age group 0-18 years old). In both groups, most patients were males from the rural area. In adults, falling was the main legal entity of the cases, followed by car accidents (which were the most common in children). In both groups, in car accidents, most of them were pedestrians and car occupants. Various aggressions (human, animal, self-injury) were found in 94 (9.68%) of the adult cases and in four (11.76%) cases of children. Another parameter under study was the blood alcohol concentration, being observed that most of the subjects with positive blood alcohol content died from car accidents. By evaluating the Glasgow Coma Scale (GCS) score as a prognostic factor, most of the subjects presented third and fourth degree coma at admission; still, 5.14% of the adult patients who deceased had GCS score 15 at admission, death occurring probably by developing some intracranial hematomas in time. Regarding the morphology of the lesions, most patients presented various forms of cranial fractures, 185 (19.05%) adults in association with extradural hemorrhages∕hematomas, but also there were four cases with extradural hematomas without any cranial fractures. In children, there was highlighted a single case of extradural hemorrhage under the fracture line. Seventy-eight percent of the adults and 44.12% of children presented subdural hematomas associated with other meningo-cerebral lesions. Also, 83.63% of the adults and 97% of children presented brain contusions. In both groups, brain laceration was observed in approximately 50% of the cases.
创伤性脑损伤（TBI）导致的死亡在全球范围内呈逐年上升趋势，主要发生在发展中国家。因此，世界卫生组织（WHO）估计，2020 年 TBI 将成为第三大主要死因。在我们的研究中，我们评估了 2011 年至 2017 年期间罗马上诉法医学研究所记录的 TBI 导致的死亡。因此，根据年龄，病例分为两组：0-18 岁（含 18 岁）和 18 岁以上（共 1005 例，其中 971 例为成年人，34 例为 0-18 岁年龄组）。在这两组中，大多数患者都是来自农村地区的男性。在成年人中，坠落是主要的法律实体，其次是车祸（在儿童中最常见）。在这两组中，在车祸中，大多数是行人和汽车乘客。在 94 例（9.68%）成人病例和 4 例（11.76%）儿童病例中发现了各种侵犯（人为、动物、自残）。作为研究的另一个参数，检测到血液酒精浓度，观察到大多数血液酒精含量呈阳性的受试者死于车祸。通过评估格拉斯哥昏迷量表（GCS）评分作为预后因素，大多数受试者入院时表现为第三和第四度昏迷；尽管如此，在死亡的成年患者中，有 5.14%的患者入院时 GCS 评分为 15，死亡可能是由于及时形成了一些颅内血肿。关于病变的形态，大多数患者表现为各种形式的颅骨骨折，185 例（19.05%）成年人伴有硬膜外出血/血肿，还有 4 例单纯的硬膜外血肿而没有任何颅骨骨折。在儿童中，发现了一例骨折线下的单一硬膜外出血。78%的成年人和 44.12%的儿童表现为伴有其他脑膜脑病变的硬膜下血肿。此外，83.63%的成年人和 97%的儿童表现为脑挫裂伤。在这两组中，约有 50%的病例观察到脑裂伤。
