Division of Laboratory Medicine, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Forensic Sci Med Pathol. 2023 Dec;19(4):507-516. doi: 10.1007/s12024-023-00584-8. Epub 2023 Feb 3.
The extensive and rapid development of the human brain during the first years of life complicates the postmortem diagnosis of brain edema in infancy. The aim of this study was to describe brain water content, the brain weight/body weight ratio, and the brain weight/head circumference ratio throughout the first years of life. Furthermore, we examined the relationship between these parameters and rs2075575 in the AQP4 gene. Our hypothesis was that dysregulated water homeostasis might be a risk factor for sudden infant death syndrome (SIDS), which may be reflected by increased water content in the brain. The study included 90 subjects with sudden unexpected death < 4 years of age: 22 cases of sudden infant death syndrome, 11 cases of sudden unexplained death in childhood, 47 cases of death due to disease, and 10 cases of accident/violent death. Brain water content, brain weight/body weight ratio, and brain weight/head circumference ratio were investigated according to corrected age, diagnosis group, attempt to resuscitate, and presence of brain edema. We found that brain water content and brain weight/body weight ratio were significantly reduced with increasing age, while brain weight/head circumference were increased. Brain weight/head circumference was correlated with brain water content. Cases with brain edema had a significantly higher brain weight/head circumference than the non-edematous cases. No differences were found between the diagnosis groups for any of the investigated parameters. In summary, the findings contribute to the current body of knowledge regarding brain growth during the first months of life.
在生命的最初几年中，人类大脑的广泛而快速发育使得婴儿脑水肿的死后诊断变得复杂。本研究旨在描述脑水含量、脑重/体重比和脑重/头围比在生命的最初几年中的变化，并探讨这些参数与 AQP4 基因中的 rs2075575 之间的关系。我们的假设是，水稳态失调可能是婴儿猝死综合征（SIDS）的危险因素，这可能反映在大脑中的水分含量增加上。本研究纳入了 90 例年龄<4 岁的意外突然死亡病例：22 例婴儿猝死综合征，11 例儿童不明原因死亡，47 例疾病死亡，10 例意外/暴力死亡。根据校正年龄、诊断组、复苏尝试和脑水肿的存在情况，研究了脑水含量、脑重/体重比和脑重/头围比。我们发现，脑水含量和脑重/体重比随年龄的增长而显著降低，而脑重/头围则增加。脑重/头围与脑水含量相关。有脑水肿的病例脑重/头围明显高于无脑水肿的病例。在所研究的参数中，各诊断组之间无差异。总之，这些发现有助于了解生命最初几个月大脑生长的现有知识体系。
