Assessing postmortem brain edema: A comparative evaluation of estimation techniques

Brain edema is frequently observed in medicolegal postmortem examinations, often presenting a challenge for forensic pathologists during routine autopsies. This article reviews the methods used to estimate the presence of postmortem brain edema during autopsy and evaluates the reliability of these measurements in determining its degree and extent. Numerous assessment procedures are utilized to estimate brain edema during autopsy. Normalized cerebral weight and wet-dry weight ratios are considered objective methods. Cautious interpretation of clinical data, imaging, gross anatomy, and histopathological findings is important for accurate estimation. Applying morphometric parameters as mathematical models based on imaging and physical measurements could facilitate more precise and objective evaluation of brain edema compared to traditional methods, as they are less dependent on the skills and expertise of the pathologist. Furthermore, emerging technologies like artificial intelligence (AI) and machine learning (ML) offer promising tools for the precise assessment of postmortem brain edema, potentially enhancing routine forensic evaluations. This review concluded that the integration of objective mathematical models and AI-assisted tools significantly improves the accuracy and reproducibility of brain edema estimation during autopsy compared to conventional methods.