Histologic Changes in the Brain in Cases of Fatal Injury to the Head

Axonal pathology in traumatic brain injury

“…Approaching the middle of last century, the pathological appearances of trauma related axonal injury were first described in human tissue where, in addition to the previously well-known macroscopic focal lesions, microscopic examination revealed TBI could also induce widespread, subtle and yet seemingly important pathological changes throughout the brain parenchyma (Rand and Courville, 1946). Apparently unique to TBI, it was proposed that these pathological white matter changes occur as a direct consequence of the mechanical forces experienced at the time of injury.…”

“…Commonly, these swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities” (Figure 1a,c-d). A more widely recognized, but not necessarily more common, axonal pathology found shortly after TBI is a large single swelling described as an “axonal bulb” (previously referred to as a “retraction ball”), which likely represents complete axonal disconnection (Figure 1a-b) (Adams, et al, 1989, Adams, et al, 1984, Adams, et al, 1982, Cajal, 1928, Chen, et al, 1999, Povlishock, 1992, Povlishock and Becker, 1985, Povlishock, et al, 1983, Povlishock, et al, 1999, Povlishock and Katz, 2005, Rand and Courville, 1946, Smith and Meaney, 2000, Smith and Meaney, 2000, Smith, et al, 2003, Strich, 1956). …”

Axonal pathology in traumatic brain injury

“…Approaching the middle of last century, the pathological appearances of trauma related axonal injury were first described in human tissue where, in addition to the previously well-known macroscopic focal lesions, microscopic examination revealed TBI could also induce widespread, subtle and yet seemingly important pathological changes throughout the brain parenchyma (Rand and Courville, 1946). Apparently unique to TBI, it was proposed that these pathological white matter changes occur as a direct consequence of the mechanical forces experienced at the time of injury.…”

“…Commonly, these swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities” (Figure 1a,c-d). A more widely recognized, but not necessarily more common, axonal pathology found shortly after TBI is a large single swelling described as an “axonal bulb” (previously referred to as a “retraction ball”), which likely represents complete axonal disconnection (Figure 1a-b) (Adams, et al, 1989, Adams, et al, 1984, Adams, et al, 1982, Cajal, 1928, Chen, et al, 1999, Povlishock, 1992, Povlishock and Becker, 1985, Povlishock, et al, 1983, Povlishock, et al, 1999, Povlishock and Katz, 2005, Rand and Courville, 1946, Smith and Meaney, 2000, Smith and Meaney, 2000, Smith, et al, 2003, Strich, 1956). …”

Animal models of traumatic brain injury

“…Commonly, swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities,” or as a large single swelling at a disconnected axon terminal described as an “axonal bulb” (previously referred to as a “retraction ball”) (Cajal, 1928; Rand and Courville, 1946; Strich, 1956; Adams et al, 1982, 1984; Povlishock et al, 1983, 1999; Povlishock and Becker, 1985; Adams et al, 1989; Povlishock, 1992; Chen et al, 1999; Smith and Meaney, 2000; Smith et al, 2003; Povlishock and Katz, 2005). The histopathologic gold standard for the identification of DAI is achieved via immunohistochemistry to visualize damaged axons accumulating the amyloid precursor protein (APP) (Gentleman et al, 1993; Sherriff et al, 1994).…”

Diagnostic History of Traumatic Axonal Injury in Patients with Cerebral Concussion and Mild Traumatic Brain Injury

“…However, in Korea, it has rarely been used in the clinical field while diffuse axonal injury (DAI) and concussion have been widely used. Since the middle of the last century, several studies have demonstrated trauma related axonal injury in the human brain using autopsy [35]. In 1982, Adams et al [36], who introduced the term "DAI" by characterizing the extent and distribution of axonal injury in patients with TBI, defined DAI as the presence of microscopic axonal injury in the white matter of the cerebral hemisphere, corpus callosum, and brainstem caused by mechanical forces following head trauma [37,38].…”

Axonal pathology in traumatic brain injury

“…Approaching the middle of last century, the pathological appearances of trauma related axonal injury were first described in human tissue where, in addition to the previously well-known macroscopic focal lesions, microscopic examination revealed TBI could also induce widespread, subtle and yet seemingly important pathological changes throughout the brain parenchyma (Rand and Courville, 1946). Apparently unique to TBI, it was proposed that these pathological white matter changes occur as a direct consequence of the mechanical forces experienced at the time of injury.…”

“…Commonly, these swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities” (Figure 1a,c-d). A more widely recognized, but not necessarily more common, axonal pathology found shortly after TBI is a large single swelling described as an “axonal bulb” (previously referred to as a “retraction ball”), which likely represents complete axonal disconnection (Figure 1a-b) (Adams, et al, 1989, Adams, et al, 1984, Adams, et al, 1982, Cajal, 1928, Chen, et al, 1999, Povlishock, 1992, Povlishock and Becker, 1985, Povlishock, et al, 1983, Povlishock, et al, 1999, Povlishock and Katz, 2005, Rand and Courville, 1946, Smith and Meaney, 2000, Smith and Meaney, 2000, Smith, et al, 2003, Strich, 1956). …”

Animal models of traumatic brain injury

“…Commonly, swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities,” or as a large single swelling at a disconnected axon terminal described as an “axonal bulb” (previously referred to as a “retraction ball”) (Cajal, 1928; Rand and Courville, 1946; Strich, 1956; Adams et al, 1982, 1984; Povlishock et al, 1983, 1999; Povlishock and Becker, 1985; Adams et al, 1989; Povlishock, 1992; Chen et al, 1999; Smith and Meaney, 2000; Smith et al, 2003; Povlishock and Katz, 2005). The histopathologic gold standard for the identification of DAI is achieved via immunohistochemistry to visualize damaged axons accumulating the amyloid precursor protein (APP) (Gentleman et al, 1993; Sherriff et al, 1994).…”

Diagnostic History of Traumatic Axonal Injury in Patients with Cerebral Concussion and Mild Traumatic Brain Injury

“…However, in Korea, it has rarely been used in the clinical field while diffuse axonal injury (DAI) and concussion have been widely used. Since the middle of the last century, several studies have demonstrated trauma related axonal injury in the human brain using autopsy [35]. In 1982, Adams et al [36], who introduced the term "DAI" by characterizing the extent and distribution of axonal injury in patients with TBI, defined DAI as the presence of microscopic axonal injury in the white matter of the cerebral hemisphere, corpus callosum, and brainstem caused by mechanical forces following head trauma [37,38].…”

Axonal pathology in traumatic brain injury

“…Approaching the middle of last century, the pathological appearances of trauma related axonal injury were first described in human tissue where, in addition to the previously well-known macroscopic focal lesions, microscopic examination revealed TBI could also induce widespread, subtle and yet seemingly important pathological changes throughout the brain parenchyma (Rand and Courville, 1946). Apparently unique to TBI, it was proposed that these pathological white matter changes occur as a direct consequence of the mechanical forces experienced at the time of injury.…”

“…Commonly, these swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities” (Figure 1a,c-d). A more widely recognized, but not necessarily more common, axonal pathology found shortly after TBI is a large single swelling described as an “axonal bulb” (previously referred to as a “retraction ball”), which likely represents complete axonal disconnection (Figure 1a-b) (Adams, et al, 1989, Adams, et al, 1984, Adams, et al, 1982, Cajal, 1928, Chen, et al, 1999, Povlishock, 1992, Povlishock and Becker, 1985, Povlishock, et al, 1983, Povlishock, et al, 1999, Povlishock and Katz, 2005, Rand and Courville, 1946, Smith and Meaney, 2000, Smith and Meaney, 2000, Smith, et al, 2003, Strich, 1956). …”

Animal models of traumatic brain injury

“…Commonly, swellings appear in a periodic arrangement along the length of an axon at the site of injury, classically referred to as “axonal varicosities,” or as a large single swelling at a disconnected axon terminal described as an “axonal bulb” (previously referred to as a “retraction ball”) (Cajal, 1928; Rand and Courville, 1946; Strich, 1956; Adams et al, 1982, 1984; Povlishock et al, 1983, 1999; Povlishock and Becker, 1985; Adams et al, 1989; Povlishock, 1992; Chen et al, 1999; Smith and Meaney, 2000; Smith et al, 2003; Povlishock and Katz, 2005). The histopathologic gold standard for the identification of DAI is achieved via immunohistochemistry to visualize damaged axons accumulating the amyloid precursor protein (APP) (Gentleman et al, 1993; Sherriff et al, 1994).…”

Diagnostic History of Traumatic Axonal Injury in Patients with Cerebral Concussion and Mild Traumatic Brain Injury

“…However, in Korea, it has rarely been used in the clinical field while diffuse axonal injury (DAI) and concussion have been widely used. Since the middle of the last century, several studies have demonstrated trauma related axonal injury in the human brain using autopsy [35]. In 1982, Adams et al [36], who introduced the term "DAI" by characterizing the extent and distribution of axonal injury in patients with TBI, defined DAI as the presence of microscopic axonal injury in the white matter of the cerebral hemisphere, corpus callosum, and brainstem caused by mechanical forces following head trauma [37,38].…”