ANALYSIS OF CASES OF CEREBRAL COMMOTION AFTER ROAD ACCIDENTS IN KRASNODAR

Aim. To examine cases of diagnose setting for cerebral commotion after road accidents within Krasnodar city, to justify the diagnose, to analyze the level of harm committed.
Materials and methods. A retrospect analysis has been done to 353 expert reports and forensic medical examination acts issued after road accidents which involved medically documented cerebral commotion. Analyzed cases have been detected by continuous sampling. Conditions taken into consideration: sex, age, circumstances, time, type of accident and type of involvement for injured people, localization and type of injury, reasons for cerebral commotion rejection from experts diagnose.
Results. As a result, 199 cases have missed cerebral commotion as experts diagnose – 63.3% of these cases missed data for dynamic neurological examination of the person aggrieved, 30.7% of cases didn’t contain objective evidence of cerebral commotion, in 3.5% of cases medical outpatient card was not provided for examination by the investigator, in 2.5% of cases cerebral commotion diagnose was cancelled by clinicians after dynamic patient follow-up. In 39% of cases cerebral commotion was diagnosed in pedestrians, in 20% of cases in car drivers, in 19% of cases car passengers were injured. In nine cases (6%) there was an accident involving motorcyclists and cyclists, 4 (3%) cases were passengers of public transport. 77% of the injured people received medical care in a hospital, 23% – on an outpatient basis. In 78% of cases with cerebral commotion there were injuries of soft tissues of the head, fractures of the skull bones were revealed in 14%. Light damage to health on the grounds of a short-term disorder is established in 45% of cases, harm to health of average severity – in 20%, serious harm – in 31%, harm to health was not determined in 4%.
Conclusion. The obtained results indicate that the diagnosis of cerebral commotion is established based on anamnesis and complaints, it doesn't reflect the objective symptoms of concussion. Dynamic monitoring of the course of craniocerebral trauma is not ensured, necessary laboratory and instrumental diagnostics are not carried out. It leads to the impossibility of taking this diagnosis into account when conducting forensic medical examination because of its unreasonableness.