Leontiev P. Forensic criteria for establishing the prescription of formation of sub- and epidural haemorrhages in living persons by data of modern radiological techniques of examination

The thesis deals with solution of the scientific-practical task of modern forensic medicine: substantiation for medicolegal assessment of prescription of formation of posttraumatic sub- and epidural haemorrhages in living persons with regard for their sex and age parameters. The object of the research was as following: patients with posttraumatic sub- and epidural haematomata, as well as medicolegal assessment of prescription of their formation. Morphological changes in the cyto- and myeloarchitectonics of the brain, structural-functional parameters of blood erythrocytes and haemoglobin in living persons with posttraumatic sub- and epidural haemorrhages with regard for their sex-age parameters in compliance with computed tomography parameters served as the subject for the research. The investigation included forensic expert examinations of living persons of both sexes and different age categories (n=161) with traumatic brain injuries accompanied with sub- and epidural haemorrhages. Tomographic signs of the prescription of formation of posttraumatic sub- and epidural haematomata in living persons were revealed with help of modern instrumental techniques of radiological diagnosis (spiral computed tomography). The haematological indices, which were the most available and effective ones in accelerated diagnosis of the prescription of appearance of posttrtaumatic sub- and epidural haemorrhages, were studied by means of including methods of examination of aggregate properties of blood cells (superficial cytoarchitectonics of erythrocytes) and coagulation haemostasis parameters (fibrinogen, prothrombin, thrombocytes) into the methodological scheme. The use of macro- and microscopic signs of posttrtaumatic sub- and epidural haematomata against a background of previous instrumental radiological methods (computed, magnetic resonance tomography) objectified the diagnostic spectrum of criteria for prescription of appearance of posttraumatic sub- and epidural haemorrhages in living persons from the viewpoint of their sex-age parameters. The thesis research revealed and compared markers for prescription of formation of epi- and subdural haematomata by data of computed tomographic examinations (parameters of density of haematomata and parameters of optical density of the intact brain). The structural-functional strategy of the appearance of haemorrhages, specificity of their formation and the character of the course of posttraumatic ischaemia within the immediate (0-21 days) and long-term (90 days) periods after injuring were analyzed on the organ, tissue and cellular levels. Morphological markers for the chronology of development of haematomata, appearance of cerebral ischaemia, destructive-degenerative processes of necrosis and organization of lesions were determined.