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尸检在道路交通事故头部创伤和创伤性脑损伤的法医及临床评估中的作用:文献综述

The Role of Autopsy in the Forensic and Clinical Evaluation of Head Trauma and Traumatic Brain Injury in Road Traffic Accidents: A Review of the Literature.

作者信息

Sacco Matteo Antonio, Verrina Maria Cristina, Raffaele Roberto, Gualtieri Saverio, Tarallo Alessandro Pasquale, Gratteri Santo, Aquila Isabella

机构信息

Institute of Legal Medicine, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy.

出版信息

Diagnostics (Basel). 2025 Feb 12;15(4):442. doi: 10.3390/diagnostics15040442.

Abstract

Road traffic accidents (RTAs) are a leading cause of morbidity and mortality worldwide, frequently resulting in traumatic brain injuries (TBIs), skull fractures, and spinal injuries. This manuscript examines the forensic aspects of head trauma caused by RTAs, focusing on the role of autopsy and imaging in diagnosing and characterizing injuries. Through a systematic review of the literature, the study highlights the mechanisms of injury, including high-speed collisions, whiplash, and pedestrian impacts, and explores their pathological consequences, such as subarachnoid hemorrhage, intracranial hemorrhage, and diffuse axonal injury. The differentiation between traumatic and non-traumatic conditions, such as aneurysmal subarachnoid hemorrhage, is emphasized to ensure accurate clinical and forensic assessments. Advances in imaging technologies, particularly virtopsy, are discussed for their potential in non-invasive documentation and analysis of head injuries, while limitations of this approach are acknowledged. Furthermore, the manuscript underscores the importance of preventive measures, including helmet and seatbelt use, vehicle safety innovations, and improved road design, in reducing the incidence and severity of RTAs. By integrating clinical, forensic, and preventive perspectives, this study provides a comprehensive framework for understanding and addressing the burden of head trauma related to RTAs.

摘要

道路交通事故(RTAs)是全球发病和死亡的主要原因,经常导致创伤性脑损伤(TBIs)、颅骨骨折和脊柱损伤。本手稿探讨了道路交通事故所致头部创伤的法医方面,重点关注尸检和影像学在损伤诊断及特征描述中的作用。通过对文献的系统综述,该研究突出了损伤机制,包括高速碰撞、挥鞭样损伤和行人碰撞,并探讨了其病理后果,如蛛网膜下腔出血、颅内出血和弥漫性轴索损伤。强调了创伤性与非创伤性情况(如动脉瘤性蛛网膜下腔出血)之间的鉴别,以确保准确的临床和法医评估。讨论了成像技术的进展,特别是虚拟解剖,因其在头部损伤的非侵入性记录和分析方面的潜力,同时也承认了这种方法的局限性。此外,手稿强调了预防措施的重要性,包括使用头盔和安全带、车辆安全创新以及改进道路设计,以降低道路交通事故的发生率和严重程度。通过整合临床、法医和预防观点,本研究为理解和应对与道路交通事故相关的头部创伤负担提供了一个全面的框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e69/11854363/1da1a1014774/diagnostics-15-00442-g001.jpg

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