Human pathology
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We describe briefly and comment upon the salient strengths and limitations of the major published theories that purport to explain the mechanism of contrecoup cerebrocortical contusions. Through the application of mechanical principles, we then present a modification, clarification, and expansion of selected aspects of several theories. Our final formulation emphasizes the injurious potential of nonuniform compressive stress and the relationship between brain lag and rotationally induced injury. The resulting theory remains faithful to the laws of physics while explaining the location and distribution of cerebrocortical contusions opposite the site of a moving head impact.
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In order to clarify the relationship between stress and sudden death, we reviewed homicidal assaults that occurred in Cuyahoga County, Ohio (metropolitan Cleveland), over the preceding 30 years. Specifically, attention was focused on the autopsy and investigative findings relating to victims who died as a direct result of physical assault without sustaining internal injuries. ⋯ Two victims survived for a time in the hospital, suffered arrhythmias throughout the hospital course, and had the described cardiac lesions at autopsy. We interpret our data as being strongly supportive of the theory of catecholamine mediation of these myocardial changes in man and of the lethal potential of stress through its effect on the heart.