Timing of cortical contusion

Oehmichen, M.; Raff, G

doi:10.1007/bf02114577

Cited by 42 publications

(3 citation statements)

References 15 publications

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“…because the vascular supply is interrupted while others are compromised by plasma enzymes (e.g., thrombin and plasmin) (93). The temporal course of histologic changes has been described in several detailed studies and reviews (15,79,80,(94)(95)(96)(97)(98). Note that there is some variability in the observations; this could reflect the patient populations studied or the criteria used for reporting cellular details.…”

Section: Invited Reviewmentioning

confidence: 99%

“…Acutely extravasated erythrocytes are easily detected on routine H&E stains immediately after injury. In a large hematoma, they can remain intact for months because their ultimate degradation is dependent on macrophages delivered via the vasculature of live tissue (15,79,80). Martius scarlet blue stain can provide better contrast than H&E; the cytoplasm of fresh red blood cells stains yellow-orange, fibrin stains red, and collagen stains blue.…”

Section: Invited Reviewmentioning

confidence: 99%

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Histology of Brain Trauma and Hypoxia-Ischemia

Rahaman¹,

Bigio²

2018

Academic Forensic Pathology

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Forensic pathologists encounter hypoxic-ischemic (HI) brain damage or traumatic brain injuries (TBI) on an almost daily basis. Evaluation of the findings guides decisions regarding cause and manner of death. When there are gross findings of brain trauma, the cause of death is often obvious. However, microscopic evaluation should be used to augment the macroscopic diagnoses. Histology can be used to seek evidence for TBI in the absence of gross findings, e.g., in the context of reported or suspected TBI. Estimating the survival interval after an insult is often of medicolegal interest; this requires targeted tissue sampling and careful histologic evaluation. Retained tissue blocks serve as forensic evidence and also provide invaluable teaching and research material. In certain contexts, histology can be used to demonstrate nontraumatic causes of seemingly traumatic lesions. Macroscopic and histologic findings of brain trauma can be confounded by concomitant HI brain injury when an individual survives temporarily after TBI. Here we review the histologic approaches for evaluating TBI, hemorrhage, and HI brain injury. Amyloid precursor protein (APP) immunohistochemistry is helpful for identifying damaged axons, but patterns of damage cannot unambiguously distinguish TBI from HI. The evolution of hemorrhagic lesions will be discussed in detail; however, timing of any lesion is at best approximate. It is important to recognize artifactual changes (e.g., dark neurons) that can resemble HI damage. Despite the shortcomings, histology is a critical adjunct to the gross examination of brains.

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Section: Invited Reviewmentioning

confidence: 99%

Section: Invited Reviewmentioning

confidence: 99%

Histology of Brain Trauma and Hypoxia-Ischemia

Rahaman¹,

Bigio²

2018

Academic Forensic Pathology

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“…The larger the hemorrhagic component, the greater the cellular response. 110 Dating/aging of contusions has produced variable results, and the following guidelines are approximate. With respect to early reactions, edema is detectable within minutes of injury, increases over the following several hours, remains stable for a few days, then declines and disappears by about 6 days postinjury.…”

Section: Primary Brain Damagementioning

confidence: 99%

Forensic Pathology of Traumatic Brain Injury

Finnie

2016

Vet Pathol

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Traumatic brain injury constitutes a significant proportion of cases requiring forensic examination, and it encompasses (1) blunt, nonmissile head injury, especially involving motor vehicle accidents, and (2) penetrating, missile injury produced by a range of highand lower-velocity projectiles. This review examines the complex pathophysiology and biomechanics of both types of neurotrauma and assesses the macroscopic and histologic features of component lesions, which may be used to determine the cause and manner of death resulting from an intentional assault or accident. Estimation of the survival time postinjury by pathologic examination is also important where malicious head injury is suspected, in an attempt to ascertain a time at which the traumatic event might have been committed, thereby evaluating the authenticity of statements made by the alleged perpetrator.Keywords traumatic brain injury, veterinary forensic neuropathology, artifacts, contusions, axonal injury, cerebral ischemia, brain edema, intracranial hemorrhage, ischemic-hypoxic encephalopathy, gunshot wounds, captive bolt stunning, age of lesions In human medicine, forensic pathology has evolved into a distinct subspecialty. While veterinary pathologists have traditionally been infrequently called on to adjudicate in forensic cases where intentional head trauma is suspected, such cases are becoming more common and require more in-depth forensic knowledge. When an animal presents with signs of external head trauma, such as scalp bruises and skin abrasions, abetted by a reliable history of a traumatic event, a diagnosis of traumatic brain injury (TBI) may be relatively straightforward. However, in the absence of visible evidence of trauma and a reliable history, the onset of neurologic signs may provide the only clue that a traumatic event has occurred, especially since grazing livestock and free-roaming companion animals are not closely scrutinized.In forensic pathology, the timing of tissue responses is often the primary medicolegal task, particularly as it may support or refute statements made by a suspected perpetrator of abuse. These pathologic determinations usually depend on an estimate of the time between a traumatic insult and death. This interval between a traumatic event and circulatory arrest is defined as the survival time and, as such, equates to duration of the brain circulation after injury, although the latter can vary among the brain regions. However, while an estimate of the survival time following head trauma is sometimes possible by the application of relevant histologic and immunohistochemical techniques, the ability to date/age an injury solely on this basis should not be overestimated. 66,75,103 It is not always possible to accurately date TBI lesions because (1) determinations are variously based on studies in humans, experimental animal models (usually laboratory rodents), or both and (2) it is not always stated from which species the data were derived and how these timings were calculated. 46 These assessments are...

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Craniocerebral Trauma and Vertebrospinal Trauma

Forensic Pathology of Trauma

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Timing of cortical contusion

Cited by 42 publications

References 15 publications

Histology of Brain Trauma and Hypoxia-Ischemia

Histology of Brain Trauma and Hypoxia-Ischemia

Forensic Pathology of Traumatic Brain Injury

Craniocerebral Trauma and Vertebrospinal Trauma

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