Berry K, Rice J
University of British Columbia, Vancouver, Canada.
Am J Forensic Med Pathol. 1994 Jun;15(2):132-7. doi: 10.1097/00000433-199406000-00008.
A 39-year-old man was rendered comatose after being struck repeatedly on the head in an altercation. After admission to the hospital, he had computed tomographic scan evidence of diffuse intraventricular and subarachnoid hemorrhage as well as cerebral edema. He shortly thereafter became "brain dead" and life-support systems were discontinued the following day. At autopsy, he had a swollen brain as well as evidence of intraventricular and subarachnoid hemorrhage. No aneurysm or other grossly obvious cause for the hemorrhage was detected. There was, however, a small laceration of the lateral wall of the right lateral ventricle in the region of the caudate nucleus and thalamus, the choroid plexus was detached bilaterally, and the fornices were separated from the corpus callosum. Microscopically, there was further evidence of disruption of the lateral wall of the lateral ventricles, with fragments of ependymal lining mixed in with choroid plexus as well as blood between the fronds of the choroid plexus, and blood dissecting along the wall of the lateral ventricle deep to the ependyma. These findings were felt to be consistent with the recently proposed thesis that tears of the tela choroidea, as part of a so-called inner cerebral trauma, might produce intraventricular and subarachnoid hemorrhage, which, in this case, proved to be fatal.
一名39岁男性在一场争斗中头部多次被击打后陷入昏迷。入院后，他的计算机断层扫描显示有弥漫性脑室内和蛛网膜下腔出血以及脑水肿。此后不久他就进入“脑死亡”状态，第二天生命维持系统被撤除。尸检时，他的大脑肿胀，并有脑室内和蛛网膜下腔出血的迹象。未检测到动脉瘤或其他明显的出血原因。然而，在尾状核和丘脑区域的右侧侧脑室侧壁有一个小裂伤，双侧脉络丛分离，穹窿与胼胝体分离。显微镜下，有进一步证据表明侧脑室侧壁破裂，室管膜衬里碎片与脉络丛混合，脉络丛小叶间有血液，血液沿侧脑室壁在室管膜深部蔓延。这些发现被认为与最近提出的论点一致，即脉络丛撕裂作为所谓的脑内创伤的一部分，可能导致脑室内和蛛网膜下腔出血，在本例中，这被证明是致命的。
