Pathological Spectrum and β-APP Immunoreactivity as a Diagnostic Tool of Diffuse Axonal Injury following Traumatic...

Area of Science:

• Neuropathology
• Forensic Pathology

Background:

• Existing grading systems for Diffuse Axonal Injury (DAI) lack standardization, posing challenges in clinical and forensic settings.
• Severe Traumatic Brain Injury (sTBI) necessitates accurate post-mortem diagnostic tools for understanding injury mechanisms and implications.

Purpose of the Study:

• To develop a novel grading system for identifying DAI using histopathological and beta-amyloid precursor protein (β-APP) markers.
• To investigate post-mortem axonal changes in severe TBI cases.

Main Methods:

• A prospective study involving 35 decedents with sTBI (GCS score ≤ 8).
• Histopathological analysis using Hematoxylin and Eosin (H&E) staining and immunohistochemistry (IHC) for β-APP on brain samples (corpus callosum, thalamus, brain stem).

Main Results:

• A grading system based on histopathological characteristics was successfully developed.
• Maximum histopathological changes were observed in cases with prolonged survival and in the corpus callosum.
• Axonal swellings were detected using H&E staining, and the thalamus showed significant histopathological and immunoreactive changes.

Conclusions:

• The developed histopathological and β-APP scoring system enables accurate post-mortem diagnosis of DAI.
• This diagnostic tool has significant forensic implications and potential to improve outcomes for sTBI patients.