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The author gives a review of the textbook prepared by the team of authors V.A. Klevno, V.V. Frolov, I.A. Frolova "Forensic medical assessment of traumatic brain injury".
The textbook serves as a good addition to the textbook on forensic medicine and contains basic information about various types of traumatic brain injury that are necessary for a forensic medical expert in the production of the most common forensic medical examination of corpses and living persons with head injuries.
The publication is intended for residents studying in the specialty "Forensic medical examination", and can also be recommended to teachers of the departments of forensic medicine, practicing forensic medical experts, graduate students, students of medical specialties, as well as a wide range of readers.

Full Text

The publishing house "Practical Medicine" has published a textbook "Forensic medical assessment of traumatic brain injury" (hereinafter - the Textbook) under the general editorship of Doctor of Medical Sciences, Professor, Head of the Department of Forensic Medicine of the Moscow State Medical University named after M.F. Vladimirsky, President of the Association of Forensic Medical Experts V.A. Klevno (Fig. 1).
The co–authors of the Textbook, V.V. Frolov and I.A. Frolova, are excellent specialists in the field of forensic medical examination with extensive practical experience. Knowledge of modern ideas about the mechanisms of formation, about the clinical and morphological manifestations of traumatic brain injury (hereinafter - TBI), its differential diagnosis with other pathological conditions, and their own long–term experience allowed the authors of the Textbook to create a holistic monographic work, which reveals a rational and effective algorithm of practical action of a forensic medical expert during forensic medical examination of a corpse in cases of various types of TBI.
The relevance of the Textbook is determined primarily by the fact that, despite the significant progress made in the study of the biomechanics of head trauma, the exact definition of the mechanisms of injury in some types of TBI remains not fully understood and not fully understood.
Currently, a unified methodological approach has not been developed that would include a strict organization of expert actions aimed at assessing, interpreting and differential diagnosis of detectable morphological signs in TBI or suspected of it, especially in cases where death occurred in conditions of non-obviousness and in the presence of aggravating somatic pathology of blood vessels and brain structures.
As the experience of practical work shows, it is very difficult to determine the nature and mechanism of the occurrence of repeated traumatic subdural hematoma, chronic subdural hematoma, assessment of basal subarachnoid hemorrhages in cases where the bones of the skull retain their integrity, and other injuries on the head are limited to soft tissues.
In addition, as evidenced by the analysis of the quality of primary forensic medical reports of deaths from TBI, the practice of conducting repeated and additional forensic examinations in the same cases, there is no unified methodological approach to the compilation of an objective and motivated "conclusion".
With this in mind, the release of the textbook "Forensic medical assessment of traumatic brain injury" by V.A. Klevno, V.V. Frolova, I.A. Frolova should be recognized as extremely timely and relevant.
Structurally, the Textbook includes a preface, 9 chapters and such a mandatory structural element as a list of literary sources. The bibliographic index of the Textbook contains references to 42 scientific works of domestic and foreign authors on the topic under consideration.

As the material is covered for each of the chapters of the Textbook, the authors provide photographs and drawings that succinctly and effectively display the corresponding action and allow for an unambiguous understanding of it. Most of the photos are copyrighted, original.
In the first chapter of the Textbook, questions of the epidemiology of TBI are presented, indicating a high proportion of head trauma both in the structure of its prevalence and in the structure of mortality from various types of trauma. The age and gender pool of victims with TBI is shown, some regional features of the prevalence of fatal brain injury are revealed, the role of alcohol intoxication as an aggravating factor in the formation of head injury conditions is shown.
In the second chapter, a modern definition of the concept of "traumatic brain injury" is given, for the unification of the expert assessment of head injuries, the classification of TBI is given, the necessary amount of clinical and morphological signs of TBI is indicated, the issues of the leading mechanisms of TBI formation are outlined.
In the following chapters, the issues of morphological characteristics and interpretation of the main types of TBI are covered in detail and in detail. It is gratifying that the authors, when considering certain problems of forensic medical examination of TBI, do not limit themselves only to theoretical analysis of pressing issues. Moreover, the Textbook analyzes the most frequent tactical operational errors made by forensic medical experts when examining corpses with head trauma, as well as errors in interpreting the results of expert research and drawing conclusions.
Noteworthy is the fact that the authors, based on the generalization of available works on TBI and their own long–term experience, offer a rational algorithm for the practical action of a forensic medical expert when conducting a forensic medical examination of a corpse in cases of various types of TBI. At the same time, in addition to the algorithm of action itself, in specific cases of examination of a corpse, this work offers samples of registration of a medical death certificate in compliance with the requirements of the Medical Classification of Diseases of the 10th revision, the formulation of a forensic medical diagnosis and drawing conclusions.
Of indisputable interest is a separate discussion of the mechanism of formation of an isolated subdural hematoma as a special variant of TBI, differential diagnosis between isolated subdural hematomas resulting from traumatic exposure and subdural hematomas occurring in various pathological conditions unrelated to trauma, as well as arguments about chronic subdural hematoma and the so-called "repeated" subdural hematoma.
I would like to draw attention to chapter 9 of the Textbook, which addresses the issues of practical situations that cause the greatest possible difficulties for a forensic medical expert, both when examining a corpse itself, and when making a forensic medical diagnosis, and when substantiating conclusions.
A successful solution of the authors should be called trips that give the maximum opportunity to disclose the tasks facing the forensic medical expert in the study of cases with head trauma and helping employees of investigative bodies to make the right decisions.
Giving a general assessment of the reviewed work, it should be stated that the team of authors has done a considerable amount of work on the creation of an applied textbook on forensic medical assessment of traumatic brain injury. It should be recognized that this work was crowned with a well-deserved success: it is distinguished by its thoroughness, exclusively practical orientation, completeness and sufficiency.
It is also necessary to note the unconditional advantages of the book: it is a concise scientific style of presentation of the material, its structuring, clarity and uniformity of approach to the choice and sequence of presentation, which facilitate the perception of information by the user.
The textbook "Forensic medical assessment of traumatic brain injury" will serve as an excellent addition to the textbook on forensic medicine, is a high-quality publication that provides a significant contribution to the training of residents studying in the specialty "Forensic medical examination". In addition, the book can be successfully used in the work of forensic medical experts, regardless of the length of expert work, to benefit teachers of forensic medicine departments, graduate students and students, as well as a wide range of readers interested in this problem.


About the authors

Aleksander Maksimov

Moscow Region State Pedagogical University

Author for correspondence.
ORCID iD: 0000-0003-1936-4448
SPIN-code: 3134-8457
ResearcherId: ABG-4192-2021

MD, PhD, Forensic Pathologist of Bureau of Forensic Medical Expertise of Moscow Region, Moscow, Russia; associate professor of M.F. Vladimirskiy Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russia

Russian Federation, 141014, Russia,24 Vera Voloshina str., Mytishchi, Moscow region,


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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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