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创伤性脑损伤后死亡个体的硬脑膜及生存时间判定:一项初步研究。

Dura mater and survival time determination in individuals who died after traumatic brain injury: a preliminary study.

作者信息

Benevento Marcello, d'Amati Antonio, Nicolì Simona, Ambrosi Laura, Baj Jacek, Ferorelli Davide, Ingravallo Giuseppe, Solarino Biagio

机构信息

Section of Legal Medicine, University of Bari, piazza Giulio Cesare, 11, Bari, 70124, Italy.

Section of Pathology, University of Bari, piazza Giulio Cesare, 11, Bari, 70124, Italy.

出版信息

Forensic Sci Med Pathol. 2025 Mar;21(1):107-114. doi: 10.1007/s12024-024-00834-3. Epub 2024 Jun 22.

Abstract

BACKGROUND

Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality among young people and is a matter of concern for forensic pathologists. Many authors have tried to estimate a person's survival time (ST) after TBI using different approaches.

OBJECTIVE

The present study aimed to present an innovative workflow to estimate the ST after TBI by observing the inflammatory reaction of the dura mater (DM).

METHODS

The authors collected DM samples from 36 cadavers (20 with TBI and 16 with no history or signs of TBI). Each sample was labelled via immunohistochemistry with three different primary antibodies, CD15, CD68, and CD3, yielding 108 slides in total. The slides were digitalized and analysed using QuPath software.

RESULTS

The DM is involved in the inflammatory response after TBI. CD15 immunoreactivity allowed us to distinguish between subjects who died immediately after TBI and those with an ST of minutes or hours. CD3 immunoreactivity can be used to differentiate subjects with an ST of days from those with other STs. Moreover, the DM samples showed an acceptable diagnostic yield even in samples with signs of putrefaction.

摘要

背景

创伤性脑损伤(TBI)是年轻人发病和死亡的主要原因之一,也是法医病理学家关注的问题。许多作者试图用不同方法估计TBI后人的生存时间(ST)。

目的

本研究旨在通过观察硬脑膜(DM)的炎症反应,提出一种估计TBI后ST的创新工作流程。

方法

作者从36具尸体(20例有TBI,16例无TBI病史或体征)收集DM样本。每个样本通过免疫组织化学用三种不同的一抗(CD15、CD68和CD3)标记,共产生108张玻片。玻片数字化后使用QuPath软件进行分析。

结果

DM参与TBI后的炎症反应。CD15免疫反应性使我们能够区分TBI后立即死亡的受试者和生存时间为几分钟或几小时的受试者。CD3免疫反应性可用于区分生存时间为几天的受试者和其他生存时间的受试者。此外,即使在有腐败迹象的样本中,DM样本也显示出可接受的诊断率。

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