RESUMO
Conclusions of 41 repeated expert evaluations of craniocerebral injuries within the framework of criminal and civil cases investigation are analyzed. Some aspects of clinical and forensic medical diagnosis of lethal and nonlethal injuries to the head, evaluation of the quality of medical care, and qualification of the severity of harm to health are discussed. Causes of typical expert errors and approaches to their prevention are shown.
Assuntos
Concussão Encefálica/diagnóstico , Traumatismos Craniocerebrais/diagnóstico , Medicina Legal , Hematoma Subdural Crônico/diagnóstico , Adulto , Concussão Encefálica/etiologia , Criança , Traumatismos Craniocerebrais/complicações , Diagnóstico Diferencial , Ecoencefalografia , Hematoma Subdural Crônico/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
The authors analyzed the results of clinical and angiographical studies of 120 patients with acute severe brain traumas. In 76 cases brain stem lesions were diagnosed during life and in 22 cases diagnosed as a primary lesion. The postmortem data confirmed primary lesion of the stem structures only in 11 cases. The conclusion made by clinicians of the primary stem lesion was based mainly on an impetuously developing picture of stem disturbances during the first hours following trauma. The angiographical data demonstrated that each type of stem lesion in an acute brain trauma has a certain angiographic symptomatology. For a more correct diagnosis the authors recommend to perform cerebral angiography even in a typical clinical picture of primary stem lesion.