标题： 胸腔高应变率损伤引起的脑血管损伤 显示英文标题

标题： Cerebrovascular injury caused by a high strain rate insult in the thorax

摘要： 由爆炸引起的原发性创伤性脑损伤（TBI）在最近的冲突中其记录的发生率和公众关注度都有所增加。 最近回顾了爆炸引起TBI的胸部机制的证据，尽管总体证据具有说服力，但分离该机制的实验数据仍然很少。 值得注意的是，一项近期的研究显示，在因胸部单发致命枪伤而死亡的受害者大脑组织中出现了毛细血管周围出血。 在此，报告了一项小型现场研究的定性结果，该研究在自然环境中隔离了高应变率损伤引起的白尾鹿（Odocoileus virginianus，体重49-80公斤）TBI的胸部机制。 在三个案例中，额叶、枕叶和/或左侧顶叶表面均存在瘀点，并伴有脉络丛的毛细血管损伤。 投射物撞击胸部的位置似乎影响了损伤的程度。 这可能是由于靠近大血管。 这里报告的数据为胸部机制导致大脑血管严重损伤提供了直接证据。 显示英文摘要

摘要： Primary blast-induced traumatic brain injury (TBI) has increased in documented incidence and public prominence in recent conflicts. Evidence for a thoracic mechanism of blast-induced TBI was recently reviewed and, while the totality is compelling, data from experiments isolating this mechanism is sparse. Notably, one recent study showed pericapillar haemorrhage in brain tissue from victims of single, fatal gunshot wounds to the chest. Here, qualitative results are reported for a small field study that isolated a thoracic mechanism for TBI caused by a high strain rate insult in white-tailed deer (Odocoileus virginianus, mass 49-80 kg) in a natural environment. In each of three cases, petechiae were present on the surface of the frontal, occipital and/or left parietal lobes, along with capillary damage in the choroid plexus. The location of the projectile impact to the thorax seemed to affect the degree of damage. This may be due to the proximity to the great vessels. The data reported here provides direct evidence of a thoracic mechanism resulting in gross injury to the cerebral vasculature.