Medicolegal implications of drugs and chemicals detected in intracranial hematomas.
Medicolegal implications of drugs and chemicals detected in intracranial hematomas.
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颅内血肿中检测到的药物和化学物质的法医学意义。
DOI：
10.1520/jfs14345j
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发表时间：
1998
影响因子：
1.6
通讯作者：
Y. Hashimoto
中科院分区：
文献类型：
--
作者：
Fumio Moriya;Y. Hashimoto
本研究的目的是确定在法医尸检病例中如何评估颅内血肿的药物发现。本文对6例颅内含药物和化学物质的血肿进行了分析。在这六起案件中，有五起案件的药物和化学物质检测呈阳性，这些药物和化学物质是受害者在受伤前自行服用的。创伤后从受伤到死亡的时间间隔为10 ~ 65 h。在去甲麻黄碱或甲苯阳性的两例患者中，颅内血肿中的这些物质浓度远高于心脏血液中的浓度。在苯巴比妥阳性的个体中，其在颅内血肿中的浓度仅略高于心脏血液中的浓度。在其余两例中，颅内血肿中检测到大量乙醇，但在心脏血液中检测到少量乙醇。在三起案件中，受伤后在医院使用了一些药物。从最初给药到死亡的时间间隔为19至60小时。在静脉注射苯妥英和/或利多卡因的两例患者中，在颅内血肿中检测到大量的这些药物。在静脉注射安定的个体中，在心脏血液中检测到大量的安定，但在颅内血肿中未检测到。颅内血肿的毒理学分析不仅可用于确定个体在受伤时是否受到乙醇的影响，而且可用于检测创伤前是否使用其他药物和化学品。但是，如果受害者在死亡前接受过治疗，则应从毒理学角度彻底审查医疗记录，因为为治疗目的施用的药物可能扩散到先前存在的颅内血肿中，这取决于血肿的大小。
The purpose of this study was to determine how drug findings in intracranial hematomas should be assessed in forensic autopsy cases. Six cases in which intracranial hematomas containing drugs and chemicals were detected were examined in this study. Of the six cases, five were positive for drugs and chemicals that had been self-administered by the victims prior to injury. Post-traumatic time interval from injury to death was in the range 10 to 65 h. In two individuals who were positive for norephedrine or toluene, the concentrations of these substances were much higher in the intracranial hematomas than in heart blood. In an individual who was positive for phenobarbital, its concentration was only a little higher in the intracranial hematoma than in heart blood. In the remaining two cases, substantial quantities of ethanol were detected in the intracranial hematomas, but little ethanol was detected in heart blood. In three cases, some drugs were administered at hospital after the injuries. The time interval from the initial drug administration to death was 19 to 60 h. In two individuals given phenytoin and/or lidocaine intravenously, substantial amounts of these drugs were detected in the intracranial hematomas. In an individual given diazepam intravenously, a substantial quantity of diazepam was detected in heart blood, but not in the intracranial hematoma. Toxicological analysis of intracranial hematomas may be useful not only for determining whether individuals were under the influence of ethanol at the time they were injured, but also for detecting pre-traumatic usage of other drugs and chemicals. However, the medical record should be reviewed thoroughly from a toxicological view point if victims underwent medical treatment prior to death because drugs administered for the purpose of medical treatment can disseminate into preexisting intracranial hematomas, depending on the size of the hematomas.