损伤与腔梗疾病因果关系法医学鉴定一例.docxVIP

损伤与腔梗疾病因果关系法医学鉴定一例 损伤与腔梗疾病因果关系法医学鉴定一例 摘要：目的：探讨损伤与疾病因果关系的法医临床学鉴定，提高在损伤与疾病因果关系的法医临床学鉴定中的认识。方法：回顾性分析一例老年人颅脑损伤后发现存在腔梗进行损伤与疾病因果关系的法医临床学鉴定。结果：该案例被鉴定人是一70岁高龄女性老人，有多年的高血压疾病病史，是腔梗疾病的好发人群，腔梗的存在与颅脑损伤无因果关系。结论：腔梗是缺血性脑血管疾病之一，多发生于高龄、有多年高血压病史的患者。腔梗由于病变很小，常位于脑相对静区，临床上多无明确神经功能缺失体征。在诊断中常规辅助检查如颅脑CT也存在一定的缺陷，如表现在不同CT机的分辩率及扫描层距存在的差异、CT检查有时出现模糊效应等对诊断影响的因素，常不能对伤前就存在的腔梗病变作出诊断而造成漏诊，从而导致损伤与疾病因果关系的法医临床学鉴定的发生。　　关键词：损伤；腔梗；因果关系；法医学鉴定　　Abstract：Objective：To investigate the causal relationship between injury and disease forensic clinical identification, increase in injury and illness causation forensic clinical identification of understanding. Methods：A retrospective analysis of a case of elderly after head injury revealed the presence of lacuna damage and disease causation in clinical forensic medicine. Results：The case of a70 years old female elderly hypertensive disease, has many years of history, is the cavity Terrier illness onset crowds, lacuna exists and traumatic brain injury without causal relationship. Conclusion：Lacuna is one of ischemic cerebral vascular disease, occur in the elderly, has many years history of hypertension patients. Lacunes due to a lesion is very small, often located in the brain is relatively quiet zone, no clear clinical neurologic deficit signs. In the diagnosis of routine examinations such as head of CT also has some defects, such as CT manifestations in different resolution and scanning interval difference exists, CT sometimes appear blurred effect on diagnostic factors, often can’t hurt existed before the lacuna infarction in making a diagnosis and result in missed diagnosis, leading to injury and illness causation forensic clinical identification of.　　Key words:Damage; Cavity stem; Causal relation; Forensic medicine appraisal　　【中图分类号】D919.4 【文献标识码】B 【文章编号】1674-7526(2021)04-0008-02　　1 案例资料　　2021年5月4日案件委托人介绍：2021年2月14日，其母亲汪某在路边被人撞倒至头部受伤，伤后在XX县中医院住院治疗，伤愈出院后于2021年5月2日在XX县人民医院作头颅CT复查发现右侧内囊后肢区存在腔梗，2021年5月4日作颅脑MRI检查发现颅内多发性腔梗存在。要求进行损伤与疾病（腔梗）因果关系的法医临床学鉴定。　　XX县中医院住