创伤性脑损伤(TBI)是全球45岁以下人群的残疾和死亡的主要原因。这篇小型综述旨在将神经病理学研究中的法医方法系统化,突出显示在外部时要注意的适当元素,放射学,自动光学,和组织学检查,特别注意免疫组织化学和分子生物学。根据这次小型审查的结果,在检查具有医学法律重要性的可疑TBI时,可以认为必须采取准确的法医方法,为了收集所有可能的证据来证实可能引起的病变的诊断,或者促成了,死亡。从这个角度来看,只有使用基于证据的协议才能达到合适的诊断,特别是在那些有其他神经病理学状况(缺血,神经变性,神经炎症,痴呆症)可能在死亡中起作用。当尸体,处于高级分解状态,被研究,在放射科,宏观和组织学分析未能给出有意义的答案。在这些情况下,免疫组织化学和分子生物学诊断至关重要,法医神经病理学家必须了解它们。特别是,MiRNAs是TBI的有前途的生物标志物,用于脑损伤识别和医学法律方面。即使需要进一步的调查来验证第一批实验研究。以同样的方式,在任何法医检查期间都应检查遗传底物,考虑到它在TBI结果中的重要性。
Traumatic brain injury (TBI) is the principal cause of invalidity and death in the population under 45 years of age worldwide. This mini-
review aims to systematize the forensic approach in neuropathological studies, highlighting the proper elements to be noted during external, radiological, autoptical, and histological examinations with particular attention paid to immunohistochemistry and molecular biology. In the light of the results of this mini-
review, an accurate forensic approach can be considered mandatory in the examination of suspected TBI with medico-legal importance, in order to gather all the possible evidence to corroborate the diagnosis of a lesion that may have caused, or contributed to, death. From this point of view, only the use of an evidence-based protocol can reach a suitable diagnosis, especially in those cases in which there are other neuropathological conditions (ischemia, neurodegeneration, neuro-inflammation, dementia) that may have played a role in death. This is even more relevant when corpses, in an advanced state of decomposition, are studied, where the radiological, macroscopic and histological analyses fail to give meaningful answers. In these cases, immune-histochemical and molecular biology diagnostics are of fundamental importance and a forensic neuropathologist has to know them. Particularly, MiRNAs are promising biomarkers for TBI both for brain damage identification and for medico-legal aspects, even if further investigations are required to validate the first experimental studies. In the same way, the genetic substrate should be examined during any forensic examination, considering its importance in the outcome of TBI.