頭部外傷の力学的評価とその臨床応用 : II 脳障害と頭蓋内血腫

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In the diagnosis of primary traumatic brain injury it is important to know the mechanical background of the injury. Clinical observations show that the natures and locations of brain injuries well correspond to the particular fashion and site of the blow. Although experimental observations show that the mass movement of the brain occur at the moment of the blow, theoretically brain injury occur by the combinations of translational and/or rotational acceleration where the skull is rigid and distortion injury where the skull is elastic. Thus, coup and contrecoup injury, gliding contusion, intermediate injury can be well comprehended and foreseen by applying the above mechanisms. Modifying factors are the irregularity of the skull base and the presence of the tentorium etc.The stochastic diagnosis of traumatic intracranial hematoma is a good example of a clinical application ofmechanical analysis. There are many items in the table for stochastic diagnosis. But the most significant informations are the state and course of consciousness after the impact, the directnon of the blow, and the side of neurological signs. Consciousness disturbance concerns the presence of the hematoma. The direction of the blow and the side of the neurological signs concern the type and the side of the hematoma. Only those three items can make the diagnosis correct no less than 90%.To take notice of the mechanical action of the blow is important and is the first step to deepen the comprehension of head trauma.
日本脳神経外科学会の論文
1978-11-15

頭部外傷の力学的評価とその臨床応用 : II 脳障害と頭蓋内血腫

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