COMPUTED TOMOGRAPHY IN DIAGNOSTICS OF SHOCK-SHOCK (INERTIAL) TRAUMATIC BRAIN INJURYASPECTS OF APPLICATION IN FORENSIC MEDICAL EXAMINATION

 

Medvedeva N.А.^1,2, Serova N.S.¹

 

1 - Sechenov University.

2 - Bureau of Forensic Medicine. Russia, Moscow.

T

o determine the radiological possibilities in detailing the biomechanics of inertial traumatic brain injury, reflecting the point of force application, shock and shockproof changes in brain structures in victims, living persons with traumatic brain injury. To evaluate the possibility of CT data in determining direct and indirect traumatic brain changes.

Materials and methods. Electronic archives of radiological methods in DICOM format of 58 victims were evaluated, with shock-shock trauma confirmed by the circumstances of the case, who underwent the procedure of forensic medical examination for traumatic brain injury at the state budgetary healthcare institution of Moscow "Bureau of Forensic Medical Examination of the Department of Health of the City of Moscow. Computed tomography and radiography of the skull bones were performed in all patients at the place of medical care.

Results. Shock damage zones in 54 cases (93%) were localized on the opposite side from the point of the primary pulse and corresponded to the propagation of the force vector. Shockproof changes were detected according to CT scans in the frontal lobes in 54 cases (93%), of which in 52 cases (89%) in combination with temporal localization. And only in 4 cases (7%), where the point of application of force was localized in the frontal region, the damage zones were also found bilaterally in the area of the frontal lobes poles, the occipital lobes remained intact in all 4 cases.

Discussion. These radiological methods make it possible not only to accurately determine the anatomical location of internal and external traumatic changes, but also to assess the degree of damage to bones, meninges, brain matter, to restore the biomechanics of injury, which directly affects the objectivity of expert conclusions in assessing the severity caused to human health. The severity of the damage caused to the victim's health should be carried out on the basis of comprehensive clinical and radiological data, only in this case can we rely on the objectivity of the expert's conclusions.

Conclusion. The mechanism of inertial trauma with the display of biomechanics and detailing the point of application of force, shock changes in the membranes and substance of the brain, as well as indirect, shockproof changes, reflect the CT data in detail. To date, the only lifetime method capable of objectifying expert conclusions in the forensic medical examination of the living with traumatic brain injury (TBI) are methods of radiological diagnostics, in particular computed tomography.

 

Keywords: forensic medical examination, inertial trauma, shock-shock TBI, traumatic brain injury, radiological diagnosis of TBI, forensic medical examination of living persons.

 

Corresponding author: Medvedeva N.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Medvedeva N.А., Serova N.S. Computed tomography in diagnostics of shock-shock (inertial) traumatic brain injuryaspects of application in forensic medical examination. REJR 2024; 14(3):20-31. DOI: 10.21569/2222-7415-2024-14-3-20-31.

Received:        02.02.24 Accepted:       11.09.24