Study of histomorphological changes in the subarachnoid hemorrhage at different time intervals between injury infliction and death.
DOI:
https://doi.org/10.37506/dmwp6a68Keywords:
Subarachnoid hemorrhage, Wound dating, Forensic pathologyAbstract
Even though biochemical and molecular methods are under research for wound dating purpose, histology of the injury is still the mainstay of wound dating technique. Significance of knowing how old the wound is can have major implication in the delivery of justice. Similarly, subarachnoid hemorrhage may need to be dated in cases where other data for wound dating are scarce. This study is designed to study the histomorphological changes in the subarachnoid hemorrhages of different time interval since injury and aim to use this information for dating of subarachnoid hemorrhage for medicolegal purpose. The histology samples of subarachnoid hemorrhage of the deceased with head injuries with known post injury interval were taken during the autopsies and divided into different groups. The gross color changes and histomorphological parameters were evaluated in each group and statistical inference was made. The result showed gross color, RBC lysis, macrophage infiltration, hemosiderin laden macrophage, fibrin deposition, collagen deposition and meningeal reactive changes significantly correlated with post injury interval. Whereas, Neutrophils, lymphocytes and phagocytosis did not correlate. RBC lysis also correlated with gross color change as well. In conclusion, histology of subarachnoid hemorrhage can be a useful tool in dating subarachnoid hemorrhage in cases where it is required.
References
García-Ballestas E, Durango-Espinosa Y, Mendoza-Flórez R, Moscote-Salazar L, Keni R, Deora H, et al. The puzzle of spontaneous versus traumatic subarachnoid hemorrhage. Apollo Medicine. 2019;16(3):141.
Claassen J, Park S. Spontaneous subarachnoid haemorrhage. Vol. 400, The Lancet. Elsevier B.V.; 2022. p. 846–62.
Modi N, Agrawal M, Sinha V. Post-traumatic subarachnoid hemorrhage: A review. Neurol India. 2016;64(7):8.
Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, et al. Subarachnoid hemorrhage: Who dies, and why? Crit Care. 2015;19(1):1–10.
Stenholm E, Project D. Analysis of Traumatic Head Injury in Kathmandu, Nepal.
Jha S, Yadav BN, Agrawal A, Thakur D, Karna A, Subedi N, et al. The pattern of fatal head injury in a teaching hospital in Eastern Nepal. Journal of Clinical and Diagnostic Research. 2011;5(3):592–6.
Grellner W, Madea B. Demands on scientific studies : Vitality of wounds and wound age estimation. 2007;165:150–4.
Alexis R, Jagdish S, Sukumar S, Pandit V, Palnivel C, Antony M. Clinical profile and autopsy findings in fatal head injuries. J Emerg Trauma Shock [Internet]. 2018 Jul 1 [cited 2020 Nov 11];11(3):205–10. Available from: /pmc/articles/PMC6182969/?report=abstract
Zimmerman A, Fox S, Griffin R, Nelp T, Fonseca Thomaz EBA, Mvungi M, et al. An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country. PLoS One. 2020 Oct 1;15(10 October 2020).
Dell’aquila M, Maiese A, De Matteis A, Viola RV, Arcangeli M, La Russa R, et al. Traumatic brain injury: Estimate of the age of the injury based on neuroinflammation, endothelial activation markers and adhesion molecules. Vol. 36, Histology and Histopathology. Histology and Histopathology; 2021. p. 795–806.
Esterov D, Bellamkonda E, Mandrekar J, Ransom JE, Brown AW. Cause of Death after Traumatic Brain Injury: A Population-Based Health Record Review Analysis Referenced for Nonhead Trauma. Neuroepidemiology. 2021 Jun 1;55(3):180–7.
Tak PP, Thurkow EW, Daha MR, Kluin PM, Smeets TJM, Meinders AE, et al. Expression of adhesion molecules in early rheumatoid synovial tissue. Vol. 77, Clinical Immunology and Immunopathology. 1995. p. 236–42.
Cummings PM, Trelka DP, Springer KM. Atlas of Forensic Histopathology [Internet]. Cambridge: Cambridge University Press; 2011 [cited 2019 Jan 21]. Available from: http://ebooks.cambridge.org/ref/id/CBO9780511920905
Ross JL, Sandberg GD, Powell SZ. Forensic Evaluation of Subarachnoid Hemorrhage. Acad Forensic Pathol. 2012;2(1):30–5.
Itabashi HH, Andrews J, Tomiyasu U, Erlich S, Sathyavagiswaran L. Forensic Neuropathology. Forensic Neuropathology. Elsevier Inc.; 2007.
Vanezis P. Interpreting bruises at necropsy. J Clin Pathol. 2001;54(5):348–55.
Cummings PM, Trelka DP, Springer KM. Post-injury intervals. In: Atlas of Forensic Histopathology [Internet]. Cambridge: Cambridge University Press; [cited 2019 Jan 21]. p. 1–27. Available from: https://www.cambridge.org/core/product/identifier/CBO9780511920905A010/type/book_part
Cao S, Zheng M, Hua Y, Chen G, Keep RF, Xi G. Hematoma Changes during Clot Resolution after Experimental Intracerebral Hemorrhage. Stroke. 2016;47(6):1626–31.
Alpers BJ FFM. The reparative processes in subarachnoid hemorrhage. J Neuropathol Exp Neurol. 1945;(4):262–8.
Naidech AM, Janjua N, Kreiter KT, Ostapkovich ND, Fitzsimmons BF, Parra A, et al. Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage. Arch Neurol. 2005;62(3):410–6.
Kim J, Lee SJ. Traumatic subarachnoid hemorrhage resulting from posterior communicating artery rupture. Int Med Case Rep J. 2020;13:237–41.
Puhaindran ME. Principles of wound healing. In: Diabetic Foot Problems [Internet]. World Scientific Publishing Co.; 2008 [cited 2020 Nov 13]. p. 395–402. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534261/
Lee JY, Keep RF, He Y, Sagher O, Hua Y, Xi G. Hemoglobin and iron handling in brain after subarachnoid hemorrhage and the effect of deferoxamine on early brain injury. Journal of Cerebral Blood Flow and Metabolism [Internet]. 2010;30(11):1793–803. Available from: http://dx.doi.org/10.1038/jcbfm.2010.137
Rustem I. Litvinov, Weisel JW. What Is the Biological and Clinical Relevance of Fibrin? Rustem. PhysiolBehav [Internet]. 2016;176(10):139–48. Available from: file:///C:/Users/Carla Carolina/Desktop/Artigos para acrescentarnaqualificação/The impact of birth weight on cardiovascular disease risk in the.pdf
Itabashi HH, Andrews JM, Tomiyasu U, Erlich SS, Sathyavagiswaran L. Dating/aging of common lesionsin neuropathology. In: Forensic Neuropathology [Internet]. Elsevier; 2007 [cited 2019 Jan 21]. p. 49–122. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780120585274500055
RE P, FC B, DK A, TR B, D D, J H, et al. The cellular, biochemical, and mechanical phases of wound healing. Schwartz’s Principles of Surgery, Ninth Edition. McGraw-Hill Professional. ISBN 978-0-07-154769-7. 2009. Fig. 9-1.
Suzuki S, Ishii M, Ottomo M, Iwabuchi T. Changes in the subarachnoid space after experimental subarachnoid haemorrhage in the dog: Scanning electron microscopic observation. Acta Neurochir (Wien). 1977;39(1–2):1–14.
BAGLEY C. Blood in the Cerebrospinal Fluid: Resultant Functional and Organic Alterations in the Central Nervous System a. Experimental Data. Blood in the Cerebrospinal Fluid: Resultant Functional and Organic Alterations in the Central Nervous System a Experimental Data. 1928;17(1):18–38.
Hammes EM. Interest in subarachnoid hemorrhage. 2015;11.
HAMMES Jr EM, in Neurology F, Foundation ROCHESTER M. REACTION OF THE MENINGES TO BLOOD [Internet]. Available from: http://archneurpsyc.jamanetwork.com/
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