Purpose To separately measure N‐acetyl aspartul glutamate (NAAG), N‐acetyl aspartate (NAA), aspartate (Asp), and glutamate (Glu) concentrations in white matter (WM) using J‐editing techniques in patients with mild traumatic brain injury (mTBI) in the acute phase. Methods Twenty‐four patients with closed concussive head injury and 29 healthy volunteers were enrolled in the current study. For extended 1H MRS examination, patients and controls were equally divided into two subgroups. In subgroup 1 (12 patients/15 controls), NAAG and NAA concentrations were measured in WM separately with MEGA‐PRESS (echo time/repetition time [TE/TR] = 140/2000 ms; δONNAA/ δOFFNAA = 4.84/4.38 ppm, δONNAAG/ δOFFNAAG = 4.61/4.15 ppm). In subgroup 2 (12 patients/14 controls), Asp and Glu concentrations were acquired with MEGA‐PRESS (TE/TR = 90/2000 ms; δONAsp/ δOFFAsp = 3.89/5.21 ppm) and TE‐averaged PRESS (TE from 35 ms to 185 ms with 2.5‐ms increments; TR = 2000 ms) pulse sequences, respectively. Results tNAA and NAAG concentrations were found to be reduced, while NAA concentrations were unchanged, after mild mTBI. Reduced Asp and elevated myo‐inositol (mI) concentrations were also found. Conclusion The main finding of the study is that the tNAA signal reduction in WM after mTBI is associated with a decrease in the NAAG concentration rather than a decrease in the NAA concentration, as was thought previously. This finding highlights the importance of separating these signals, at least for WM studies, to avoid misinterpretation of the results. NAAG plays an important role in selectively activating mGluR3 receptors, thus providing neuroprotective and neuroreparative functions immediately after mTBI. NAAG shows potential for the development of new therapeutic strategies for patients with injuries of varying severity.

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The objective of the present study was the forensic medical evaluation of the importance of clinical and morphological manifestations of the venous thromboembolic complications (VTEC) for the early diagnostics of pulmonary thromboembolism. The article presents a detailed information about the VTEC morbidity rate and mortality from pulmonary artery thromboembolism (PATE) with special reference to the possible clinical variants and outcomes of this pathology. The importance of studying VTEC morbidity is substantiated. An episode from the personal expert practical work is reported to illustrate errors of lifetime diagnostics of pulmonary artery thromboembolism. Special attention is given to the necessity of the comprehensive examination of the patients presenting with VTEC for the lifetime diagnostics of pulmonary artery thromboembolism. The great value of the comprehensive pathological anatomic (forensic medical) investigation for postmortem diagnostics of VTEC is emphasized. It is concluded that the integrated approach is needed to the conduction of forensic medical expertise of the subjects presenting with the manifestations of the venous thromboembolic complications.