Abstract：
Whiplash injury is common in traffic accidents, and severe whiplash is characterized by cervical spinal cord injuries with cervical dislocation or fracture, that can be diagnosed by postmortem computed tomography (PMCT), postmortem magnetic resonance (PMMR), or conventional autopsy. However, for cervical spinal cord injury without fracture and dislocation, PMMR can be more informative because it provides higher resolution of soft tissues. We report the case of a 29-year-old male who died immediately following a traffic accident, in which the vehicle hit an obstacle at a high speed, causing deformation of the bumper and severe damage of the vehicle body. PMCT indicated no significant injuries or diseases related to death, but PMMR showed patchy abnormal signals in the medulla oblongata, and the lower edge of the cerebellar tonsil was herniated out of the foramen magnum. The subsequent pathological and histological results confirmed that death was caused by medulla oblongata contusion combined with cerebellar tonsillar herniation. Our description of this case of a rare but fatal whiplash injury in which there was no fracture or dislocation provides a better understanding of the potentially fatal consequences of cervical spinal cord whiplash injury without fracture or dislocation and of the underlying lethal mechanisms. Compared with PMCT, PMMR provides important diagnostic information in forensic practice for the identification of soft tissue injuries, and is therefore an important imaging modality for diagnosis of whiplash injury when there is no fracture or dislocation.
摘要：
鞭打伤在交通事故中很常见，严重鞭打的特征是颈脊髓损伤伴颈椎脱位或骨折，可以通过验尸计算机断层扫描(PMCT)来诊断，死后磁共振（PMMR），或者传统的尸检.然而,用于无骨折脱位的颈脊髓损伤，PMMR可以提供更多的信息，因为它提供了更高的软组织分辨率。我们报道了一名29岁男性在交通事故后立即死亡的案例，车辆高速撞击障碍物，导致保险杠变形和车身严重损坏。PMCT显示没有与死亡有关的重大伤害或疾病，但PMMR显示延髓有斑片状异常信号,小脑扁桃体的下边缘从大孔突出。随后的病理和组织学结果证实，死亡是由延髓挫伤合并小脑扁桃体疝引起的。我们对这种罕见但致命的鞭打伤没有骨折或脱位的病例的描述，可以更好地了解没有骨折或脱位的颈脊髓鞭打伤的潜在致命后果以及潜在的致死机制。与PMCT相比,PMMR在法医实践中提供了重要的诊断信息，用于鉴定软组织损伤，因此，当没有骨折或脱位时，是诊断鞭打损伤的重要影像学方法。
