Department of Forensic Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2022 Jan-Mar;63(1):169-179. doi: 10.47162/RJME.63.1.18.
Numerous studies showed that, at present, traumatic brain injury (TBI) is one of the main causes of death in young adults, but also a main cause of disabilities at all ages. For these reasons, TBI are continuously investigated. In our study, we evaluated the histopathological (HP) and immunohistochemical (IHC) changes that occurred in the brain in underage patients after a severe TBI depending on the survival period. We histopathologically and immunohistochemically analyzed a number of 22 cases of children, deceased in Dolj County, Romania, following some severe TBI, undergoing autopsy within the Institute of Forensic Medicine in Craiova between 2015-2020. Patients were divided into three groups depending on the survival period, namely: (i) patients who died during the first 24 hours of the accident; (ii) patients who died after seven days of survival; (iii) patients who died after 15 days of survival. Microscopic examinations of the brain fragments, collected during the necropsy examination, showed that the traumatic agent caused primary injuries in all brain structures (cerebral parenchyma, meninges, blood vessels). However, HP injuries ranged in size and intensity from one area to another of the brain. In patients with a longer survival period, there was observed the presence of smaller primary injuries and larger secondary injuries. There was also observed a growth in the number of meningo-cerebral microscopic injuries, depending on the increase of the survival period.
许多研究表明，目前创伤性脑损伤（TBI）是导致年轻人死亡的主要原因之一，也是各年龄段致残的主要原因。出于这些原因，TBI 仍在不断研究中。在我们的研究中，我们评估了未成年患者在严重 TBI 后根据生存时间发生的脑组织病理学（HP）和免疫组织化学（IHC）变化。我们对 2015 年至 2020 年期间在克卢日-纳波卡法医研究所进行尸检的罗马尼亚多尔日县因一些严重 TBI 而死亡的 22 例儿童病例进行了组织病理学和免疫组织化学分析。患者根据生存时间分为三组：（i）事故发生后 24 小时内死亡的患者；（ii）存活 7 天后死亡的患者；（iii）存活 15 天后死亡的患者。对尸检中收集的脑片段进行显微镜检查显示，创伤剂在所有脑结构（脑实质、脑膜、血管）中均造成原发性损伤。然而，HP 损伤的大小和强度从大脑的一个区域到另一个区域不等。在存活时间较长的患者中，观察到原发性损伤较小，继发性损伤较大。脑膜脑微观损伤的数量也随着生存时间的增加而增加。
