Nagappan Ramaswamy, Das Siddhartha, Chaudhari Vinod Ashok, Adole Prashant Shankarrao, Jinkala SreeRekha, Thazhath Harichandrakumar Kottyen
Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Department of Forensic Medicine and Toxicology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.
Int J Legal Med. 2025 Jan;139(1):95-103. doi: 10.1007/s00414-024-03332-x. Epub 2024 Sep 11.
In forensic pathology, identifying causes of death in traumatic brain injuries (TBIs) devoid of observable signs presents a significant challenge. Post-mortem biochemistry plays a crucial role in forensic medicine, particularly in determining causes of death in TBIs that lack macroscopic or histopathological evidence. This study aimed to evaluate the utility of Neuron Specific Enolase (NSE) and S100 Calcium Binding Protein B (S100B) in post-mortem serum and cerebrospinal fluid (CSF) as markers for TBI. The relationship of these biochemical markers with survival time and post-mortem interval was also studied. The study sample consisted of 63 cases each from the TBI and the Non-TBI (NTBI) group. The NTBI group comprised of deaths due to mechanical asphyxia, myocardial infarction and isolated trunk trauma. While serum S100B and CSF NSE emerged as a promising marker for TBI, CSF S100B failed to differentiate TBI from the other causes of death. The absence of an association between the level of markers and survival time or post-mortem interval in TBIs highlights the limitations of these biomarkers in such contexts. This study underscores the potential of biochemical markers like serum S100B and CSF NSE in identifying TBI deaths, aiding forensic diagnoses where there are evidentiary limitations in traditional methods. Further research exploring additional markers and body fluids could enhance diagnostic precision in forensic neuropathology.
在法医病理学中,确定无明显体征的创伤性脑损伤(TBI)的死亡原因是一项重大挑战。死后生物化学在法医学中起着关键作用,尤其是在确定缺乏宏观或组织病理学证据的TBI的死亡原因时。本研究旨在评估神经元特异性烯醇化酶(NSE)和S100钙结合蛋白B(S100B)在死后血清和脑脊液(CSF)中作为TBI标志物的效用。还研究了这些生化标志物与生存时间和死后间隔的关系。研究样本包括来自TBI组和非TBI(NTBI)组的各63例病例。NTBI组包括因机械性窒息、心肌梗死和孤立性躯干创伤导致的死亡。虽然血清S100B和脑脊液NSE成为TBI的一个有前景的标志物,但脑脊液S100B未能将TBI与其他死亡原因区分开来。TBI中标志物水平与生存时间或死后间隔之间缺乏关联,凸显了这些生物标志物在此类情况下的局限性。本研究强调了血清S100B和脑脊液NSE等生化标志物在识别TBI死亡方面的潜力,有助于在传统方法存在证据限制的情况下进行法医诊断。进一步探索其他标志物和体液的研究可能会提高法医神经病理学的诊断精度。