Kokki Jenni, Oura Petteri
Department of Forensic Medicine, University of Helsinki, P.O. Box 21, FI-00014, Helsinki, Finland.
Department of Forensic Medicine, University of Helsinki, P.O. Box 21, FI-00014, Helsinki, Finland; Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.
J Forensic Leg Med. 2025 Jan;109:102796. doi: 10.1016/j.jflm.2024.102796. Epub 2024 Dec 2.
Chronic alcohol use is often associated with traumatic brain injury (TBI). This study aimed to compare background characteristics, injury circumstances, primary head injuries, and secondary brain injuries among TBI cases with and without a documented history of chronic alcohol use. The sample comprised neuropathologically examined medico-legal autopsy cases with acute head injuries from Helsinki, Finland, over the years 2016-2022. Data on chronic excessive alcohol use were collected from medical records and police files; other background and circumstantial data were collected from medical records, police files, and cause-of-death investigation documents; and data on primary head injuries and secondary brain injuries were collected from autopsy and neuropathology reports. The dataset comprised 47 cases, of whom 19 had a history of chronic alcohol use (40.4%). Assault was the most common circumstance of injury among chronic alcohol users (47.4%) while falls prevailed among control cases (32.1%); unknown circumstances were common among both groups. There were no statistically significant differences in the prevalence of primary head injuries or postinjury survival between the groups. As for secondary brain injuries, hypoxic-ischaemic neuronal injury was significantly more common among chronic alcohol users in the frontal cortex (84.2% vs. 28.6%), parietal cortex (84.2% vs. 32.1%), hippocampus (63.2% vs. 25.0%), and lenticular nucleus (73.7% vs. 21.4%). Our findings suggest that chronic alcohol users may not necessarily have more diverse or complex primary injuries, but they may have more extensive secondary injuries. Further research should aim to explore the potential aetiology of hypoxic-ischaemic neuronal injury among chronic alcohol users.
长期饮酒常与创伤性脑损伤（TBI）相关。本研究旨在比较有和没有慢性饮酒记录史的TBI病例的背景特征、损伤情况、原发性头部损伤和继发性脑损伤。样本包括2016年至2022年期间来自芬兰赫尔辛基的经神经病理学检查的急性头部损伤的法医学尸检病例。从医疗记录和警方档案中收集慢性过量饮酒的数据；其他背景和情况数据从医疗记录、警方档案和死因调查文件中收集；原发性头部损伤和继发性脑损伤的数据从尸检和神经病理学报告中收集。数据集包括47例病例，其中19例有慢性饮酒史（40.4%）。在慢性饮酒者中，袭击是最常见的损伤情况（47.4%），而对照组中跌倒占主导（32.1%）；两组中不明情况都很常见。两组之间原发性头部损伤的患病率或伤后生存率没有统计学上的显著差异。至于继发性脑损伤，缺氧缺血性神经元损伤在慢性饮酒者的额叶皮质（84.2%对28.6%）、顶叶皮质（84.2%对32.1%）、海马体（63.2%对25.0%）和豆状核（73.7%对21.4%）中明显更常见。我们的研究结果表明，慢性饮酒者不一定有更多样化或复杂的原发性损伤，但可能有更广泛的继发性损伤。进一步的研究应旨在探索慢性饮酒者中缺氧缺血性神经元损伤的潜在病因。
