报告39例小脑扁桃体疝性脑挫伤，其中钝器打击33例，枪弹创6例，并对其病理学改变及发生机理进行观察与探讨。认为小脑扁桃体疝性脑挫伤是由于小脑扁桃体在头部遭受暴力的瞬间，撞击枕骨大孔边缘所发生的一类远区脑挫伤。见于加速性损伤，多数与冲击性脑挫伤相伴随，常累及延髓，且以线状颅骨骨折多见，伤后死亡较为迅速。熟悉该类损伤，对分析损伤性质，确定和解释死因以及估计伤后存活时间有一定的实际意义。 Reported 39 cases of cerebellar tonsil herniation brain contusion, including 33 cases of blunt hit, bullet wound in 6 cases, and its pathological changes and the mechanism of occurrence were observed and discussed. That the cerebellar tonsil hernia brain contusion is due to the cerebellar tonsil suffered violence in the head moment, hit the foramen magnum in a class of far-edge brain contusion occurred. Seen in accelerated injury, most accompanied by impact of cerebral contusion, often involving the medulla oblongata, and more common in line skull fractures, the more rapid death after injury. Familiar with this type of injury, to analyze the nature of damage, to determine and explain the cause of death and to estimate the survival time after injury has some practical significance.