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FORENSIC ASSESSMENT OF HEMORRAGE IN THE BRAIN AS A
RESULT OF CRANIOCEREBRAL INJURIES
Jarimbetov Rashid Jumanazarovich
https://doi.org/10.5281/zenodo.13923420
In a developed country, 3-4 people per 1000 inhabitants occur every year.
Such injuries are the leading cause of death and disability in the 30s. 1.5 million
annually worldwide. people lost their lives and 2.4 mln. a person becomes
disabled. By 2010, the number of people with disabilities worldwide will reach
150 million. has reached Light, it has 10-20 times more than heavy types.
There are a lot of reasons for taking peace, and in the document there is a
special place for bodily injury in road traffic accidents, falling from a distance,
quarreling incident or criminal diseases. Almost all countries have a high rate of
death due to traffic accidents. They often occur during labor resistance.
Skull fracture. in 20% of cases, it is manifested by a fracture of the skull,
and its appearance ends with death. The remaining intracranial hematomas
(epidural, subdural, intracerebral) are formed. , infections and development of
purulent processes (abscess, meningitis, meningoencephalitis) in open fractures
of the skull are very high. If the child is exposed to various bacteria, the
inflammatory processes in the brain and spinal cord are aggravated.
Pneumocephaly, i.e., air in the cerebrospinal tract, and liquorrhinorrhea, i.e., the
discharge of cerebrospinal fluid from the nose, are also used for skull
fractures.There are linear, open and pressed (crushed) fractures of the skull.
Individual skull base fractures are also distinguished.Among these, linear
fractures of the skull are very common, and in most cases they occur upward or
upward from the point of impact. Epidural and subdural hematomas often occur
in linear fractures.A fracture of the base of the skull is often accompanied by a
fracture of the dome of the skull. A blow to the occipital bone can fracture the
base of the skull separately. Such fractures occur in the pyramid of the temporal
bone, the pons, the Turkish saddle, or the calvaria. Licorice root, pneumocephaly
and carotid-cavernous fistula help a lot in the fracture of the base of the skull.
and hemorrhages appear in the middle ear, nipple-like div, and eye socket.
These symptoms are additional signs of a skull base fracture.
Liquor rhinorrhea is associated with the transfer of cerebrospinal fluid to
the nasal sinuses through the calcareous plate of the calcareous bone. If liquor-
rhinorrhea persists for a long time, requiring a surgical operation to restore the
integrity of the dura mater at the fracture site of the skull. Sometimes it is
difficult to determine where the liquid is flowing. For this, a water-soluble
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contrast is injected into the cerebrospinal fluid through CT, and the place where
the cerebrospinal fluid flows is identified. If liquor-rhinorrhea appears and
persists, correction, surgical intervention is required. Sometimes the flow of
liquor stops suddenly.
Fractures of the Turkish saddle are common in skull base injuries. This
fracture is not always detected on X-ray. When the Turkish saddle is broken, the
pituitary gland and the optic nerve are often damaged. If it is detected in the
sinus, the base of the Turkish saddle is broken.In diseases of the pyramid of the
temporal bone VIII, VII and nerves are damaged, cerebrospinal fluid and blood
flow from the ear. In a transverse fracture of the pyramid, the shell and labyrinth
are always damaged.When the frontal bone is fractured, most often, the eyeball
and maxillofacial sinuses are injured. If the cranial nerve is injured, the sphenoid
nerve is also injured and the anosmia is injured. Cranial nerve injury. Cranial
nerves, especially nerves I, II, III, V, VII, VIII, are often damaged when the base of
the skull is fractured. Bulbar nerves are rarely damaged.If acute anosmia occurs
in KSJ, the filter nerve is severely damaged. In this case, the causes of anosmia
are hematoma of the anterior cranial cavity, compression of the nerve from the
side of the forehead or severing of the sphincter nerve. If the anosmia does not
disappear within a few months, the filtering function is usually not
restored.Fractures of the temporal bone cause the optic nerve to be crushed or
severed. In this case, a one-sided amblyopia develops, and the correct reaction of
the pupil to light is lost, while the partner reaction is preserved. The shape of the
pupils usually does not change. When the optic nerve is partially damaged,
visual function decreases and sectoral defects appear in the field of vision.
A full ophthalmoplegia syndrome develops in an eyeball injury, and the
porous tissue around the eye swells. When the small wing of the sphenoid bone
is broken, the coiled nerve is damaged. In this case, diplopia is observed when
looking down, and it disappears when the head is turned from the affected side
to the opposite side. Facial nerve damage can occur immediately after CSJ. This
nerve is often damaged when the pyramid of the temporal bone is fractured.
Damage to the atrium-cranial nerve also occurs in fractures of the pyramid
of the temporal bone and is manifested by hearing loss, dizziness, vestibular
ataxia, and nystagmus. These symptoms develop immediately after the injury.
Hearing loss may not be due to damage to the auditory nerve, but to a ruptured
eardrum or bleeding in the middle ear.When assessing the clinical types of
craniocerebral injuries and their severity, attention is paid first of all to how long
unconsciousness has been lost, whether the injury is open or closed.Mild
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concussion is an injury manifested by concussion and light crushing of the brain.
Loss of consciousness usually lasts 30 minutes, and post-traumatic numbness
and amnesia last up to an hour.Focal neurological symptoms and meningeal
signs are not observed. Usually, the soft tissues of the head are damaged.
According to the Glasgow scale, mild KSJ is equal to 15-13 points.In the middle
CSJ, the patient loses consciousness from 30 minutes to 1 hour, a state of
numbness or sopor occurs, and post-traumatic amnesia lasts from 1 hour to 24
hours. Moderate concussion corresponds to moderate contusion of the brain.
Skull fractures, post-traumatic intracranial hemorrhage, including subarachnoid
hemorrhage, occur in moderate injuries. Vital functions equal to 12-9 points of
intermediate level of KSJ on the Glasgow scale. Mild to moderate damage.
Severe TBI is an injury characterized by severe crushing and compression of the
brain and diffuse axonal damage. The patient loses consciousness for more than
1 hour, post-traumatic amnesia lasts for more than 24 hours, the activity of vital
centers (cardiovascular and respiratory) is disrupted, focal neurological
symptoms appear, epileptic seizures occur. gives Recovery is slow or
incomplete. On the Glasgow scale, severe CSJ is 8-3 points.
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