Age determination of brain contusions.

In 104 individuals who had sustained traumatic brain injury, the course of traumatically induced morphological changes was investigated immunohistochemically during the first 30 weeks after the trauma. Regarding the inflammatory cell reaction in human cortical contusions, CD15-labeled granulocytes were detectable within 10 minutes following brain injury, whereas significantly increased numbers of nuclear leukocytes occurred after a postinfliction interval of at least 1.1 days (leukocyte common antigen), 2 days (CD3), or 3.7 days (UCHL-1), respectively. A positive nuclear staining for the proliferation marker MIB-1 by cerebral macrophages could be observed as early as 3 days after the injury and regularly in cases with a survival between 7 and 11 days. Injury-induced glial staining reactions could be demonstrated, at the earliest, after a postinfliction interval of 3 hours for α1-antichymotrypsin, 22 hours for vimentin, 1 day for glial fibrillary acidic protein, and 7 days for tenascin. Regarding the vascular response to brain injury, a significantly increased immunoreactivity could be detected in cortical contusions with a wound age of at least 3 hours for factor VIII, 1.6 days for tenascin, and 6.8 days for thrombomodulin, whereas the immunostaining for laminin and type IV collagen was regularly whereas the immunostaining for laminin and type IV collagen was regularly positive even in the vascular endothelium of ininjured brain tissue.