NCJ Number
53163
Journal
Zeitschrift fuer Rechtsmedizin Volume: 81 Issue: 2 Dated: (1978) Pages: 79-96
Date Published
1978
Length
18 pages
Annotation
THE CHARACTERISTIC SIGNS AND CAUSES OF TRAUMATIC ASPHYXIA ARE OUTLINED ON THE BASIS OF PREVIOUS LITERATURE AND INVESTIGATION OF 11 VICTIMS.
Abstract
ACCORDING TO FINDINGS IN HUMANS AND ANIMALS, CHARACTERISTICS OF THE CONDITION ARE THORACIC COMPRESSION AS WELL AS INSPIRATION AND CLOSING OF THE GLOTTIS IMMEDIATELY BEFORE TRAUMA, SO THAT INTRATHORACIC PRESSURE INCREASES AS VENOUS BLOOD BACKS UP IN VALVELESS CRANIOCERVICAL VEINS AND CAUSES VENOUS ECTASIS, CYANOSIS, AND SPOT BLEEDING ON THE HEAD, NECK, SHOULDERS, AND CHEST. RESULTS FROM HISTOMORPHOLOGICAL EXAMINATION OF 11 TRAIN ACCIDENT VICTIMS SHOW FOUR WITH THE TYPICAL SIGNS OF TRAUMATIC ASPHYXIA MENTIONED ABOVE, AS WELL AS EDEMA, LUNG CONGESTION, LIVER CELL DESTRUCTION, VASCULAR, HEART, AND BRAIN HYPEREMIA, AND HIGH CATECHOLAMINE VALUES. BONE MARROW MICROEMBOLISMS IN SOME CASES MAY RESULT FROM MECHANICAL TRAUMA TO BONES, HEMODYNAMIC DYSREGULATION FROM TRAUMATIC ASPHYXIA, AND SHOCK REACTIONS. DEATH FROM TRAUMATIC ASPHYXIA APPARENTLY IS CAUSED BY CONCURRENT EFFECTS OF THREE MECHANISMS: (1) HEMODYNAMIC EFFECTS, ESPECIALLY PULMONARY CONGESTION, (2) SUFFOCATION FROM IMPAIRMENT OF THERACIC AND ABDOMINAL BREATHING, AND (3) A PULMONARY MICROEMBOLISM SYNDROME WITH MANY BONE MARROW AND FAT EMBOLISMS. IT IS CONCLUDED THAT TRAUMATIC ASPHYXIA INDUCES PATHOLOGICAL EVENTS AND FINDINGS DIFFERENT FROM SIMPLE ASPHYXIA, ALTHOUGH TRANSITION FORMS EXIST, TRAUMATIC ASPHYXIA IS RELATED BOTH TO VITAL REACTIONS AND TO CONSCIOUS SHOCK REACTIONS; THAT HISTOMORPHOLOGICAL FINDINGS RESULTING FROM OXYGEN DEPRIVATION, BLOOD MALDISTRIBUTION, AND DISTURBANCES OF THE BLOOD SUPPLY CAN BE USED TO REACH A DIAGNOSIS; AND THAT THE DIAGNOSIS IS FURTHER SUPPORTED BY HIGH CATECHOLAMINE CONCENTRATIONS. AN EXENSIVE BIBLIOGRAPHY, EIGHT ILLUSTRATIONS, AND TWO TABLES ARE SUPPLIED. --IN GERMAN (KMD)