关键词: 法医临床学, 交通事故, 颅脑外伤, 伤残评定, 脑卒中残损评价表, 日常生活能力量表, Fugl-Meyer评定表

Abstract: Objective To determine the optimal assessment time for motor and sensory disability due to traumatic brain injury (TBI).Methods 108 cases involving traumatic brain injuries in traffic accidents with different injury time(3,6,9,12,15,18 months),were collected,including medical history,radiology and electricphsiology materials.Patient families were interviewed; forensic examination and medical diagnosis were made;and disability degrees were determined.Patients were examined using Stroke Impairment Assessment Set(SIAS),Activity of Daily Living Scale(ADL),and Fugl-Meyer Assessment(FMA).Diagnosis and disability assessments were based on all of the above information.Results SIAS,ADL and FMA showed good distinction between different levels of disability and different injury time.The complete samples demonstrated that there was no statistically significant difference for SIAS,ADL and FMA.The average values in SIAS,ADL and FMA showed no difference for injuries from 6 to 18 months in light disability.The average values in SIAS,ADL and FMA from 9 to 18 months showed no difference in mild disability.For severe disability,there was no statistically significant difference of the average value for SIAS,ADL and FMA from 12 to 18 months.Conclusion Motor and sensory disability should be assessed after medical treatment is finished.For mild disability(grades 7-10),the best time is 6 months after injury.For moderate disability(grades 4-6),the best time is 9 months.For severe disability(grades 1-3),the best time is more than 12 months after injury,and can be delayed according to specific clinical situations.

Key words: clinical forensic medicine, traffic accidents, brain injury, disability evaluation, SIAS, ADL, FMA