Axonal Injury in Closed Head Injury by Assault: A Quantitative Study
| Autor: | G. Vowles, C. L. Scholtz, Stephen E. Greenwald, S. Evans, D. A. Crooks |
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| Rok vydání: | 1992 |
| Předmět: |
Pathology
medicine.medical_specialty Silver Time Factors Poison control Violence Diagnostic aid 03 medical and health sciences 0302 clinical medicine medicine Humans 030216 legal & forensic medicine Staining and Labeling Glial fibrillary acidic protein biology Immunoperoxidase business.industry Health Policy Head injury Brain Forensic Medicine medicine.disease Axons Issues ethics and legal aspects nervous system Glial reaction Brain Injuries 030220 oncology & carcinogenesis Closed head injury Time course biology.protein Regression Analysis business Law |
| Zdroj: | Medicine, Science and the Law. 32:109-117 |
| ISSN: | 2042-1818 0025-8024 |
| DOI: | 10.1177/106002809203200204 |
| Popis: | Due to the controversy in the literature regarding the time course of axonal balloon formation in human material, we wished to determine if it was possible to diagnose axonal injury before the development of axonal balloonings. The hypothesis was that the presence of axonal swellings or axonal enlargements associated with a glial reaction could be used as a diagnostic aid in human axonal injury before 12 hours. The brains of eight individuals that survived for less than 48 hours following head injury, and also had evidence of axonal injury using the criteria of Vanezis et al. (1987), were systematically studied by looking at axonal swellings, axonal balloonings, reactive astrocytes, maximum diameter of axonal enlargements and density of axonal enlargements. Controls were eight selected cases without neurological disease. The variables studied were assessed in 25 fields from ten different areas of the brain, using silver stains and immunoperoxidase for glial fibrillary acidic protein (GFAP). Logarithms of one plus the count of each variable were taken from the raw data and these were analysed using percentile distribution and the median, the t-test, Mann-Whitney U test and the Wilcoxon signed rank test. We conclude that quantitation of axonal damage allows the detection of mild degrees of axonal injury that could be overlooked on routine examination, and that the criteria of axonal enlargements, rather than axonal balloonings, are indications of axonal damage, cannot be endorsed with the evidence provided. |
| Databáze: | OpenAIRE |
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