85例成人闭合性脑挫伤组织病理学研究

目的研究大脑及脑干脑挫伤后组织病理学变化及与损伤时间的关系,并比较大脑与脑干损伤之间有无差异。方法对85例闭合性颅脑损伤死亡的脑挫伤组织进行病理学GFAP、HSP70、NF200免疫组织化学染色。结果脑损伤早期出现的胞浆嗜酸性肿胀胶质细胞(ECSG)是脑损伤后一种早期应激性反应,挫伤部位淀粉样小体(CA)的增多及噬神经细胞现象也可在脑挫伤后早期形成,而脑干挫伤ECSG发生率高于大脑。中性粒细胞浸润、泡沫细胞及胶质瘢痕形成有一定时序性。结论ECSG在判断生前脑挫伤及推断脑挫伤时间中有重要的参考价值。在ECSG较多的部位,泡沫细胞及CA也较多,三者之间可能存在联系,并提出CA是脑挫伤后反应性产物之一,可用于推断脑损伤时间。

The study of forensic histopathology of 85 adults of the human brain contusion

Objective To study the pathological changes between the cerebra and brain stem contusion the relationships of the pathological changes to the injury time. Methods 85 adults of brain contusion of the closed head injury were investigated with pathological and immunohistochemistry methods. Results It was shown that the eosinophilic cytoplasmic swelling of glia (ECSG) appeared in the early stage of the injuries was an immediately stress response to the brain injury, and that there were more ECSG in the brain stem than in the cerebral tissue. Corpora amylacea (CA) and neuronophagia increased in the early stage after the injury. Neutrophil leukocytes, foamy macrophages and the glial scars have a real-time changes after the brain contusion. Conclusion ECSG has an important referential value in determining the ante-and postmortem brain contusion and the post-injury interval. The sources of ECSG are discussed. At the accumulation area of the ECSG, the foamy macrophages and CA were also found increased, and it is predicted that there might be some correlativity among the three changes. CA may be used to determine the post-injury interval for the forensic medicine.