Neuropathology and brain weight in traumatic-crush asphyxia

Al‐Sarraj, Safa; Laxton, Ross C.; Swift, Benjamin M. C.; Kolar, Alexander J.; Chapman, R.C.; Fegan-Earl, Ashley; Cary, N.

doi:10.1016/j.jflm.2017.08.009

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…It would seem logical that the same processes may well apply to the cranial vasculature in instances of venous hypertension. Such an explanation for the origin of the subdural hemorrhage in the cases identified in this study would appear to be supported by the finding of perivascular intracere-bral hemorrhages in two of the cases involving compression of the neck structures-an observation that has previously been reported by others in instances of traumatic (crush) asphyxia (27).…”

Section: Original Articlesupporting

confidence: 84%

“…Is it possible that it is cranial venous hypertension may be a factor, at least in some cases-rather than head trauma by way of impact injury or forcible and repetitive shaking? This cranial venous hypertension theory may go some way in explaining the apparent discrepancy between forces required experimentally to rupture dural bridging veins and the quantification of forces actually generated in models of abusive infantile shaking (39)(40)(41)(42), as well as the limited radiological and pathological data suggestive of neck injury in cases of infant deaths traditionally attributed to shaking (27,43). However, it is acknowledged that different mechanistic processes may be operative in infant cases from the post-infantile pediatric and adult cases described in this study.…”

Section: Original Articlementioning

confidence: 99%

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Non-Traumatic Acute Subdural Hemorrhage Due To Cranial Venous Hypertension

Orde¹

2019

Academic Forensic Pathology

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Acute subdural hemorrhage is typically associated with a history of head trauma, and as such it is a finding with significant potential medicolegal consequences. In this article, 37 adult and post-infantile pediatric sudden death autopsy cases with small volume (“thin film” or “smear”) acute subdural hemorrhage are presented—in which there is either no further evidence of head trauma or only features of minor head injury. The possible underlying pathophysiological mechanisms are explored, and it is concluded that a common thread in many of these cases is likely to have been cranial venous hypertension at around the time of death. These findings may have implications in instances where small volume subdural hemorrhage is identified in the absence of other evidence of significant head injury.

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Section: Original Articlesupporting

confidence: 84%

Section: Original Articlementioning

confidence: 99%

Non-Traumatic Acute Subdural Hemorrhage Due To Cranial Venous Hypertension

Orde¹

2019

Academic Forensic Pathology

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“…Some researchers conducted a comprehensive neuropathological examination on the autopsy data of 20 patients with traumatic asphyxia (TA) caused by different factors. The results showed that there was a tendency to increase brain weight in patients with TA, with severe cerebral vascular congestion, perivascular hemorrhage and occasional β‐APP deposition, which was consistent with early axonal destruction (Al‐Sarraj S, et al, 2017). Some studies have shown that if a patient has hypoxic‐ischemic encephalopathy (HIE) before death, the disappearance of cerebral hemispheric sulcus and the loss of contrast at the basal ganglia level can be found by computer tomography (PMCT) after brain death (Shirota G, et al, 2016).…”

Section: Morphology and Pathology Of Cerebral Ischemiamentioning

confidence: 72%

Research progress of IGF‐1 and cerebral ischemia

Zhou

et al. 2021

Ibrain

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Cerebral ischemic disease is a group of diseases that cause insufficient blood supply to the cerebrum, cerebellum or brain stem for different reasons, resulting in corresponding nervous system symptoms. Cardiovascular disease is the leading cause of death in the world. Among them, the death caused by cerebral ischemia accounts for the vast majority, and it is one of the fatal diseases in the middle‐aged and elderly at present. Epidemiologic studies have projected increasing mortality due to cardiovascular disease worldwide (about 23.3 million people by 2030) because of the aging population. However, related studies have shown that insulin‐like growth factor I (IGF‐1) is a multifunctional cell proliferation regulator. It plays an important role in cerebral ischemia. It is effective in promoting cell differentiation, proliferation and individual development. Studies have shown that IGF‐1 signaling pathway is a key pathway controlling cell growth and survival. There may be five mechanisms in cerebral ischemia: prevention of intracellular calcium overload, inhibition of the upregulation of nNOS, IGF‐1upregulations activating HIF‐1α, regulation of Bcl‐2 to resist apoptosis, and enhancement of vascular endothelial function. Three critical nodes in the IGF‐1 signaling pathway have been described in cardiomyocytes: protein kinase Akt/mammalian target of rapamycin (mTOR), Ras/Raf/extracellular signal‐regulated kinase (ERK), and phospholipase C (PLC)/inositol 1,4,5‐triphosphate (InsP3)/Ca2+. IGF‐1 plays an important role in cerebral ischemia and myocardial ischemia, mainly by activating downstream of IGF‐1, controlling cell death and differentiation or transcription work, improving the function of heart muscle cells, reducing the myocardial cell apoptosis induced by myocardial infarction, regulating endogenous protection and restoration of cerebral ischemia injury, thus protecting cerebral and myocardial injury. Related studies have shown that bcl‐2 exerts great influence on both cerebral ischemia and myocardial ischemia. Therefore, the relevant pathways and targets of cerebral ischemia and myocardial ischemia and the role of IGF‐1 in protecting the heart are reviewed in this paper.

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“…Both respiratory inhibition and hemodynamic disturbances contribute to cerebral impairment in TA [ 11 , 12 ]. However, their respective role is yet to be determined with not striking pathologic changes except congested vessel and petechial perivascular hemorrhage [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of 51 pediatric cases of traumatic asphyxia

Luo

Zhai

Xie

et al. 2022

J Cardiothorac Surg

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Background Traumatic asphyxia (TA) is a rarely reported disease characterized as thoraco-cervico-facial petechiae, facial edema and cyanosis, subconjunctival hemorrhage and neurological symptoms. This study aimed to report 51 children of TA at the pediatric medical center of west China. Methods Scanned medical reports were reviewed and specific variables as age, sex, cause of injury, clinical manifestations and associated injuries were analyzed using SPSS 25.0. Results The average age of patients was 5.3 ± 2.9 (1.3–13.2) year-old. Thirty (58.8%) were boys and 21 (41.2%) were girls. Most TAs occurred during vehicle accident, object compression and stampede. All patients showed facial petechiae (100.0%, CI 93.0–100.0%), 25 (49.0%, CI 34.8–63.2%) out of 51 presented with facial edema, 29 (56.9%, CI 42.8–70.9%) presented with subconjunctival hemorrhage, including bilateral 27 and unilateral 2. Six patients had facial cyanosis (11.8%, CI 2.6–20.9%). Other symptoms were also presented as epileptic seizure, vomiting, incontinence, paraplegia, etc. The most frequent companion injury was pulmonary contusion (76.5%, CI 64.4–88.5%). Other companion injuries included mediastinal emphysema, fracture, cerebral contusion and hemorrhage, hypoxic-ischemic brain injury, abdominal organ contusion, mastoid hemorrhage, hematocele of paranasal sinuses, spinal cord injury, hepatic insufficiency, myocardial injury and retinal hemorrhage and edema. Treatment was mainly supportive. No death occurred in our study. The prognosis is rather good if without damage of central nervous system. Conclusion TA could bring out multiple symptoms, among which retinal hemorrhage and edema, spinal cord injury and viscera impairment have been less observed. Comprehensive physical and auxiliary examination should be performed considering TA. Its prognosis is rather good with focus on life-threatening complications.

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Neuropathology and brain weight in traumatic-crush asphyxia

Cited by 4 publications

References 15 publications

Non-Traumatic Acute Subdural Hemorrhage Due To Cranial Venous Hypertension

Non-Traumatic Acute Subdural Hemorrhage Due To Cranial Venous Hypertension

Research progress of IGF‐1 and cerebral ischemia

A retrospective study of 51 pediatric cases of traumatic asphyxia

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