Hypertrophic olivary degeneration is usually caused by a lesion in the triangle of Guillain and Mollaret. The inciting pathology includes ischemic, inflammatory, degenerative or, less frequently, traumatic lesions. Clinically, it is usually accompanied by palatal myoclonus or other forms of segmental myoclonus. We present four patients with hypertrophic olivary degeneration studied with MRI after severe head trauma. MRI was performed between 5 and 18 months respectively after trauma. Although post-traumatic tremor was observed in three patients, none of patients showed palatal myoclonus. MRI showed multiple post-traumatic lesions within the dentato-rubro-olivary pathway associated with enlargement and increased signal intensity of the inferior olives.
Craniocerebral Trauma ; Humans ; Magnetic Resonance Imaging ; Myoclonus ; Olea ; Pathology ; Tremor

In the researches of biomechanics for child craniocerebral injury, the research progress of performance parameter detection for brain, skull, cranial suture and dura mater, and the finite element model construction for child's head were reviewed. Meanwhile, the shortcomings of the established finite element model construction of child's head were analyzed. Thus, it is necessary to strengthen the material properties parameter detection of child's head, and establish the relevant database, so as to lay the foundation for establishing an accurate finite element model of child's head.
Biomechanical Phenomena ; Brain/pathology* ; Child ; Craniocerebral Trauma/physiopathology* ; Finite Element Analysis ; Head/pathology* ; Humans ; Skull/pathology*

Traumatic intracranial lesion has been one of the most frequent and serous problem in neurosurgical pathology. CT made it possible to get prompt diagnosis and surgical intervention of intracranial lesions by its safety, fastiness and accuracy. Computed tomographic scan was carried out on 1309 cases at Soonchunhyang Chunan Hospitalfor 15 months from Oct. 1983 to Dec. 1984. We have reviewed the computed tomographic scans of 264 patients whichshowed traumatic intracranial lesion. The results were as follows: 1. Head trauma was the most frequentlydiagnosed disase using computed tomographic scans(57.8%), and among 264 cases the most frequent mode of injury wastraffic accident (73.9%). 2. Skull fracture was accompained in frequency of 69.7% and it was detected in CT in38.6%: depression fractue was more easily detected in 81%. 3. Countercoup lesion(9.5%) was usually accompained with temporal and occipital fracture, and it appeared in lower incidence among pediatric group. 4. Intracranial lesions of all 264 cases were generalized cerebral swelling(24.6%), subdural hematoma(22.3%), epiduralhematoma(20.8%), intracerebral hematoma(6.1%), and subarachnoid hemorrhage(3.0%). 5. The shape of hematoma wasusually biconvex(92.7%) in acute epidural hematoma and cresentic(100%) in acute subdural hematoma, but the morechronic the cases became, they showed planoconvex and biconvex shapes. 6. Extra-axial hematoma was getting decreased in density as time gone by. 7. Hematoma density was not in direct proportion to serum hemoglobin levelas single factor.
Chungcheongnam-do ; Craniocerebral Trauma ; Depression ; Diagnosis ; Hematoma ; Hematoma, Subdural, Acute ; Humans ; Incidence ; Pathology ; Skull Fractures

OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
Craniocerebral Trauma/pathology* ; Humans ; Personality ; Personality Disorders/psychology* ; Personality Inventory ; Psychotic Disorders/psychology*

OBJECTIVES: To study the forensic features of diffuse brain atrophy after trauma, the relationship between age and interval time of post-traumatic brain atrophy, and the relationship between the degree of craniocerebral injury and that of brain atrophy. METHODS: The forensic features of 25 cases of diffuse brain atrophy after craniocerebral trauma were retrospectively analyzed from aspects of gender, age, craniocerebral injury characteristics, and imaging characteristics of brain atrophy. Pearson correlation analysis was used for statistical analysis. RESULTS: Diffuse brain atrophy after trauma could occur in any age group, dominated by severe brain injury. The Pearson correlation coefficients （r） between the time interval of brain atrophy and age were 0.442 （ P<0.05）, 0.341 （P>0.05）, and 0.904 （ P<0.05） for the overall cases, the group over age 50, and the group under age 50, respectively. The correlation coefficient between the degree of brain injury and that of brain atrophy was 0.579 （ P<0.05）, and that between severe brain injury and brain atrophy was 0.788 （ P<0.05）. CONCLUSIONS The more serious the brain injury, the more severe the brain atrophy. Various degrees of diffuse brain atrophy can occur in severe craniocerebral injury, and diffuse brain atrophy is usually mild and moderate after mild and moderate craniocerebral injury. In the practice of forensic clinical identification, a comprehensive analysis should be conducted with the combination of case materials when the identified person has high risk factors leading to brain atrophy （e.g., hypertension, diabetes, etc.）, plus injury and illness relationship analysis if necessary.
Atrophy ; Brain/pathology* ; Brain Injuries/complications* ; Craniocerebral Trauma ; Humans ; Retrospective Studies

OBJECTIVETo assess the morphologic changes in traumatic cerebral infarction and to discuss its mechanism.

METHODSSpecimens from seventeen cases of cerebral infarction were selected from 81 patients with severe brain injury, and subject to routine gross and histological examinations.

RESULTS(1) The cerebral infarction in all cases was hemorrhagic in nature with a wedged or irregular shape upon gross inspection. The lesions were found in occipital gyrus (8 cases), occipital lobes (3 cases), basal nuclei (3 cases), cingulate gyrus (2 cases), and lateral occipitotemporal gyrus (1 case). Histologically, the lesions were located at the junction between the cortex and medulla, showing congestion, edema, hemorrhage, necrotic nerve tissue and blood vessels. In severe cases, the lesion extended into the entire cortex and subarachnoid spaces. (2) Swelling of the brain and cerebral hernia were found in all cases, 8 of which demonstrated that the posterior cerebral artery was compressed and stenotic within the space between the crus cerebri and uncus.

CONCLUSIONBrain tissue necrosis in traumatic cerebral infarction is the result of brain swelling and cerebral hernia formation, following congestion, bleeding and ischemia due to vasculature compression.

Adolescent ; Adult ; Brain ; pathology ; Brain Edema ; complications ; Cerebral Infarction ; etiology ; pathology ; Craniocerebral Trauma ; complications ; Encephalocele ; complications ; Female ; Humans ; Male

Autopsy by forensic pathologist is a main mean currently to determine the cause of sudden unexpected death. Retinal examination is important but seldom performed during a forensic autopsy for various reasons. The value of retina examination has not been recognized. With invention of ophthalmic endoscopy and its subsequent application in postmortem retina examination, it has proved to be useful adjunct to determine the cause of death and to estimate the postmortem interval.
Adult ; Autopsy ; Cause of Death ; Craniocerebral Trauma/pathology* ; Decompression Sickness/pathology* ; Female ; Forensic Pathology/methods* ; Humans ; Male ; Middle Aged ; Ophthalmoscopy ; Retina/pathology* ; Subarachnoid Hemorrhage/pathology* ; Syndrome ; Vitreous Hemorrhage/pathology*

Since first application of computed tomography (CT) in postmortem examination in 1990, investigators have been discussing the value and advantage of CT in full-body examination in cadaver. CT examination before autopsy is able to provide not only the informations to guide the autopsy, but also the significant findings to analysis the causes of death, which may be not fount in autopsy. This review focuses on the value of CT in analysis of the death causes, injury manners, and personal identifications in postmortem examination as well as its development in the field of forensic medicine. It is our belief that CT in combination with other newly developed technologies will make more contribution to forensic medicine in the future.
Autopsy ; Cause of Death ; Craniocerebral Trauma/pathology* ; Forensic Pathology ; Heart Diseases/pathology* ; Humans ; Imaging, Three-Dimensional ; Lung Diseases/pathology* ; Postmortem Changes ; Tomography, X-Ray Computed ; Wounds and Injuries/pathology*

OBJECTIVE: To analyze the features of orbital fracture and to discuss its forensic expertise points. METHODS: One hundred and thirty cases of simple orbital fracture from 2010 to 2012 collected from one public security bureau were retrospectively analyzed such as age, gender, tools, position and morphology of the fracture, periorbital and orbital compound injury and the follow-up results after 6 months. RESULTS: In the 130 cases, the wounded were mainly young men and hit by fist. The fracture of simple medial orbital wall accounted for up to 81.5% in all cases. In the periorbital and orbital compound injury, laceration and contusion of eyelid and ethmoidal cellules and maxillary sinus always occurred. After 6 months follow-up, there were 30 cases of comminuted fracture remained enophthalmos compared with the uninjured side. CONCLUSION It is inappropriate to judge the fracture of simple medial orbital wall as minor injury. We should judge the degree of simple orbital fracture after the injury is stable. Detailed ophthalmology inspection is necessary for forensic expertise of simple orbital fracture.
Craniocerebral Trauma ; Enophthalmos ; Female ; Fractures, Comminuted/pathology* ; Humans ; Male ; Ophthalmologic Surgical Procedures ; Orbit ; Orbital Fractures/surgery* ; Retrospective Studies ; Severity of Illness Index ; Trauma Severity Indices

BACKGROUND AND OBJECTIVES: Canal paresis in patients with BPPV has been variously reported to present in 13% to 57%. Should disorders affecting the peripheral vestibular system, such as vestibular neuronitis, head trauma precede or coexist the onset of BPPV, then particle repositioning maneuver (PRM) may be less effective or ineffective and need further vestibular rehabilitation after the particle repositioning maneuver. The purpose of this study is to investigate the clinical feature and importance of vestibular rehabilitation in patients with BPPV associated with canal paresis. MATERIALS AND METHODS: A retrospective review was made of 212 patients who visited and diagnosed as BPPV at Hallym university medical center from March 2004 to September 2006. We evaluated the coexistence of canal paresis, methods of treatment and outcome of 128 patients who performed bithermal caloric test. RESULTS: The vestibular assessment by bithermal caloric test showed the canal paresis in 28 patients. In 21 patients, the canal paresis was ipsilateral, in 2 patients, it was contralateral to the BPPV, and in 5 patients, canal paresis was bilateral. Among 28 patients with canal paresis, 12 patients demonstrated as primary BPPV, 16 patients as secondary BPPV. 28 patients with canal paresis were performed PRM. Vestibular rehabilitation was performed in 18 patients who had ongoing symptoms such as nonspecific continuous dizziness after PRM. Among 18 patients, 14 patients were improved, 4 patients were treatment resistant. CONCLUSION: This study shows the importance of detailed vestibular testing such as bithermal caloric test in BPPV patients. Patients with evidence of concomitant vestibular pathology would be expected to require further vestibular rehabilitation.
Academic Medical Centers ; Caloric Tests ; Craniocerebral Trauma ; Dizziness ; Humans ; Paresis* ; Pathology ; Rehabilitation ; Retrospective Studies ; Vertigo* ; Vestibular Neuronitis