Brain macrophages in human cortical contusions as indicator of survival period

Abstract

SummaryThe aim of this study was to establish a morphologie time sehe me with which cases of cerebral contusion with unknown survival periods can be dated. Our study of 275 cases was limited to qualitative and quantitative changes in macrophages. The appearance of macrophages and their distribution as weIl as their content of neutral fat, esterified chol· esterol, erythrocytes, siderin, hematoidin, and ceroid were correlated with the survival period. For each cytologic criterium, the observation period, distribution-free limits of tolerance, and relative frequency of identification in different survival periods were determined, and the limits of confidence calculated. The findings permit the dating of trauma in cases with unknown survival periods. Moreover, the probability of this dating was calculated.

A quantitative immunohistochemical study on the time-dependent course of acute inflammatory cellular response to human brain injury

“…Polymorphonuclear infiltrations adjacent to the necrotic neuronal parenchyma of rats were present earliest at day 2 and decreased further with time [10]. In human brain tissue polymorphonuclear leucocytes have been found within a few hours of injury [5,12,14,17], emanating from vessels and invading the damaged tissue [5]. In contrast to these findings we found a rather early leucocyte reaction adjacent to the damaged cortical area by immunohistochemical staining.…”

“…The course of reactions to cerebral traumatic contusions has been studied over the years regarding early processes, such as traumatically induced edema or neuronal damage and to late reactions, specifically in relation to the developement of the macrophage (microglial) response [14,15], the evolution of the glial scar and the fate of blood pigments. On the other hand, comparatively few reports exist on the course of the inflammatory cellular response to cortical contusions in human brain tissue and in animals.…”

“…In the central nervous system (CNS) the cellular accumulation including neutrophils and mononuclear macrophages is thought to be implicated in the pathogenesis of secondary brain injury after trauma, specifically contributing to alterations in cerebral blood flow, edema, intracranial hypertension, and ultimately neuronal death [6,18]. As information on the course of the post-traumatic cellular reaction may contribute to a forensic wound age estimation [7,[12][13][14], the time-dependent appearance of polymorphonuclear and mononuclear leucocytes positively staining for CD 15, LCA, UCHL-1 and CD 3 was investigated in human cortical contusions by immunohistochemistry.…”

Mechanical Trauma and Classification of Wounds

“…A survey of first appearance as well as additional statistical data and last appearance of a definite morphological phenomenon is given in Table 19.5. An actual survey on the time-dependent histological alterations is given by Oehmichen et al (2003), associated with important statistical data (for further information, especially regarding the interaction of macrophages see Oehmichen et al 1986Oehmichen et al , 2009b.…”

The science behind the quest to determine the age of bruises—a review of the English language literature

“…Macrophages are present in normal skin [143] making it more difficult to determine when an infiltration has commenced. They are increased from around 12 h in traumatic lesions of the human brain [146,151]. In human skin wounds, macrophages have been reported from 3 [145] or 7 [152] hours, with a peak around 1-2 days, [152] outnumbering neutrophils from 20 h [145].…”