Perivasal cerebral microhaemorrhages accompanied with acute increase of intrathoracic and intra-abdominal pressure

Authors

HIRT Miroslav KRAJSA Jan VOJTÍŠEK Tomáš ĎATKO Miroslav

Year of publication 2016
Type Conference abstract
Citation
Description The acute increase of intrathoracic and intra-abdominal pressure of any causation leads to a sharp compression of organs, including the heart and large vessels. According to the principle of liquid (blood) displacement, the shock wave spreads through the vascular system to the peripheries. When a wave of increased pressure arrives at the thinnest location of vascular wall – this being located in capillaries – it brings about a rupture of the capillary wall resulting in haemorrhage into the perivascular spaces. This occurrence is not only histologically detectable in many tissues, but can also be macroscopically visible on certain cross sections of the brain’s white matter. Cerebral haemorrhage is, by its essence, the most dangerous occurrence. During the last few years the Institute of Forensic Medicine in Brno dedicated significant research effort to this topic. These occurrences are common findings when investigating fatal ballistic trauma of the thorax and the abdomen, though sometimes require a more thorough search. In the brain the majority of haemorrhages are to be found in the basal ganglia, often consisting of only a few erythrocytes. The assumption suggests that perivascular micro haemorrhages in the brain occur not only on fatal, but also on non-fatal ballistic trauma of the abdomen and thorax. With the advancements of modern surgery we can register an increasing amount of successfully operated surviving patients living until old age. As of today no research has yet been conducted with the focus on the after-effects of these small occurrences, including theoretical possibility of psychological problems based on the morphologic brain micro traumas, nothing to say of e.g. the congenital defects of the arterial wall.

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