9783540235002

Abbreviations

xxi

Introduction

(4)

I Principles of Forensic Neuropathology

(90)

Risks, Responsibilities and Liabilities

(8)

Basic Principles

(4)

Identity of the Victim

(1)

Manner of Death

(1)

Cause of Death

(1)

Process of Dying

(1)

Causation

(1)

German Theories of Causation

(1)

American Theories of Causation

(1)

Role of Expertise and Expert Witness

(4)

Definition: Expert Witness

(1)

Standards in (the American) Court

(1)

Function of Expert Witness

(1)

Probability of Expert Opinion

(1)

Bibliography

(1)

References

(3)

Cytology of the CNS

(26)

Neurons

(5)

Morphology

(2)

Function

(2)

Pathology

(1)

Astrocytes

(4)

Morphology, Classification, and Immunoreactivity

(1)

Function

(3)

Pathology

(1)

Reactive Astrogliosis

(1)

Piloid Gliosis

(1)

Metabolic (Protoplasmic) Gliosis

(1)

Regressive Alterations

(1)

Oligodendrocytes

(3)

Morphology, Classification, and Immunoreactivity

(1)

Function

(1)

Pathology

(1)

Microglia and/or Mononuclear Phagocytes of the CNS

(5)

Morphology, Classification, and Immunoreactivity

(1)

Pathology

(3)

Function

(1)

Resting Microglia

(1)

Perivascular Microglia

(1)

Activated Microglia (Macrophages)

(1)

Additional Cell Types and Tissue Components

(9)

Leptomeningeal and Perivascular Cells

(1)

Parenchymal Vessels

(1)

Choroid Plexus and Ependyma

(1)

Pathology of the CSF and Cells Within the CNS

(1)

Bibliography

(1)

References

(7)

Cell and Tissue Reactions

(42)

Increased Brain Volume -- Edema

(12)

Definition

(1)

Clinical Features

(2)

Pathogenesis

(1)

Types of Brain Edema

(1)

Vasogenic Edema

(3)

Cytotoxic Edema

(1)

Conclusion

(1)

Neuropathology

(1)

Space-Occupying Effects

(2)

Herniation

(1)

Uncal Herniation

(2)

Cingulate Herniation

(1)

Central Transtentorial Herniation

(1)

Upward Tentorial Displacement

(1)

Forensic Implications

(1)

Hydrocephalus

(2)

Classification and Pathogenesis

(1)

Neuropathology

(1)

Clinical Features

(1)

Cell and Tissue Decay

(11)

Injury-Induced Cell Death: Necrosis

(1)

Incomplete Necrosis

(1)

Tissue Necrosis: Infarction

(2)

Gene-Regulated Cell Death: Apoptosis

(2)

Necrosis Versus Apoptosis

(1)

Penumbra

(1)

Dendritic Injury

(1)

Axonal Injury

(1)

Anterograde (Wallerian) Degeneration

(1)

Retrograde Degeneration

(1)

Regenerative Capacity

(1)

Inflammation

(6)

Principles of Neuroimmunology

(1)

Inflammatory Cells

(2)

Polymorphonuclear Leukocytes

(1)

Lymphocytes

(1)

Microglia and Brain Macrophages

(1)

Astrocytes

(1)

Endothelial Cells and Collagen Fibers

(1)

Inflammatory Mediators

(1)

Cytokines

(1)

Chemokines

(1)

Effector Molecules

(1)

Types of Inflammation

(1)

Sterile Inflammation

(1)

Cell-Mediated Inflammation

(1)

Antibody-Mediated Inflammation

(1)

Inflammation-Induced Ischemia

(1)

Misinterpretable Findings

(10)

Gross Findings

(1)

Microscopic Findings

(1)

Bibliography

(1)

References

(7)

Methods in Forensic Neuropathology

(12)

Macroscopic Examination

(7)

Principles of Brain Autopsy

(1)

Biosafety

(1)

Preserved Native Material

(1)

Documentation

(1)

Brain

(1)

Fixation Procedures

(1)

Examination during Autopsy

(1)

Sectioning of the Formalin-Fixed Brain

(1)

Block Selection for Microscopy

(2)

Paraffin Embedding

(1)

Special Problems

(1)

Spinal Cord

(1)

Peripheral Nerves

(1)

Microscopic Examination

(1)

Postmortem Imaging

(5)

Bibliography

(1)

References

(3)

II Physical Trauma

(176)

Basic Principles of Mechanical Trauma

(14)

Classification

(1)

Epidemiology of Mechanical Brain Injury

(1)

Forensic Aspects

(1)

Biomechanical Aspects and Pathomorphology

(5)

Physical Quantities

(1)

Mechanical Forces

(2)

Types of Mechanical Brain Injury

101

(1)

Pathology

102

(1)

Secondary Lesions

103

(1)

Clinical Features

104

(2)

Somatic Symptoms

104

(1)

Neuropsychological Impairment

105

(1)

Outcome

106

(1)

Medicolegal Principles

106

(5)

Bibliography

107

(1)

References

107

(4)

Injuries of the Brain's Coverings

111

(40)

The Scalp

113

(2)

Anatomy

113

(1)

Pathophysiology

113

(1)

Pathology

113

(1)

Abrasion Injury

114

(1)

Contusion Injury

114

(1)

Hematoma

114

(1)

Laceration Injury

114

(1)

Avulsion Injury

114

(1)

The Skull

115

(5)

Anatomy

115

(1)

Biomechanical Aspects

116

(1)

Linear Calvarial Fracture

117

(1)

Depressed Calvarial Fracture

117

(1)

Combined Fractures

117

(1)

Basilar Skull Fracture

117

(3)

Facial Skull Fracture

120

(1)

Growing Skull Fracture

120

(1)

Clinical Features

120

(1)

Dura Mater

120

(3)

Anatomy

120

(1)

Pathology

120

(3)

Secondary Lesion (Herniation Syndrome)

123

(1)

Epidural Hemorrhage

123

(3)

Classification

123

(1)

Biomechanical Aspects

123

(2)

Pathology

125

(1)

Clinical Features

125

(1)

Prognosis

125

(1)

Subdural Hemorrhage

126

(9)

Classification

126

(1)

Biomechanical Aspects

127

(2)

Clinical Features

129

(1)

Types and Causes of SDH

129

(1)

Prognosis

129

(1)

Diagnosis

130

(1)

Pathology

130

(1)

Acute SDH

130

(2)

Subacute SDH

132

(1)

Chronic SDH

132

(3)

Internal Hemorrhagic Pachymeningitis

135

(1)

Hygroma

135

(1)

Histology and Microscopic Dating of EDH and SDH

135

(3)

Injuries of Intracranial Vessels

138

(8)

Mechanically Induced Subarachnoid Hemorrhage and Intraventricular Hemorrhage

139

(1)

Biomechanical Aspects

139

(2)

Clinical Features

141

(1)

Pathology and Differential Diagnosis

142

(1)

Delayed Mechanically Induced Apoplexy

143

(1)

``False'' Aneurysm

143

(1)

Dissecting Aneurysm

144

(1)

Mechanically Induced Arterial Thrombosis

144

(1)

Injury of the Veins

145

(1)

Injury of the Sinuses (Sinus Thrombosis)

145

(1)

Carotid Artery -- Cavernous Sinus Fistula (Carotid-Cavernous Fistula, CCF)

145

(1)

Injuries of the Extracranial Arteries

146

(1)

Injury of the Carotid Artery

146

(5)

Injury of the Vertebral Artery

147

(1)

Bibliography

147

(1)

References

147

(4)

Open Brain Injuries

151

(26)

Basic Principles

151

(1)

Classification

151

(1)

Biomechanical Aspects

151

(1)

Pathology

151

(1)

Stabbing and Incision Wounds

152

(2)

Gunshot Wounds

154

(17)

Clinical Features and Capability to Act

155

(4)

Biomechanical Aspects

159

(2)

Pathology

161

(1)

Scalp

161

(1)

Skull

162

(3)

Brain

165

(2)

Postmortem Imaging

167

(1)

Homicide, Suicide, Accident

168

(1)

Dating of Gunshot Wounds

169

(2)

Secondary Lesions

171

(6)

References

173

(4)

Closed Brain Injuries

177

(40)

Classification

177

(2)

Concussion Injury and Cortical Hemorrhage

179

(15)

Biomechanical Aspects

179

(4)

Injury by Fall

183

(1)

Injury by Blow

184

(1)

Cellular and Molecular Mechanisms

185

(1)

Cytological Reaction

185

(2)

Necrosis

187

(1)

Apoptosis

188

(1)

ApoE-Genotype

189

(1)

Pathology

189

(1)

Concussion Injury

189

(1)

Contusion Injury

189

(1)

Posterior Fossa Hemorrhage

190

(1)

Scar Formation

190

(1)

Dating of Cortical Hemorrhages

190

(4)

Intracerebral Hemorrhages

194

(8)

Classification

194

(2)

Pathology and Differentiation

196

(2)

Brain Stem Hemorrhages

198

(1)

Primary Brain Stem Hemorrhage

199

(1)

Secondary Brain Stem Hemorrhage

200

(1)

Intraventricular Hemorrhage

201

(1)

Diffuse Brain Injuries

202

(6)

Edema

202

(2)

Ischemia

204

(1)

Axonal Injury

205

(2)

Vascular Lesion

207

(1)

Boxing Brain Injury (Punch Drunk Syndrome)

207

(1)

CNS Involvement in Mechanical Injury without Primary Brain Injury

208

(9)

Fat Embolism

208

(1)

Air Embolism

209

(1)

Vascular Injury

210

(1)

Coagulation Disorders

210

(1)

Ischemic Injury

210

(1)

Bibliography

210

(1)

References

210

(7)

Injuries of Spine and Spinal Cord

217

(24)

Basic Principles

217

(4)

Epidemiology

217

(1)

Anatomy

218

(1)

Pathophysiology

219

(1)

Clinical Features

219

(1)

Biomechanical Aspects

220

(1)

Spinal Cord Injury (SCI)

221

(12)

Subdural and Epidural Hemorrhage

221

(1)

Penetrating SCI

221

(2)

Stab Wound

223

(1)

Gunshot Wound

223

(1)

Disruption of the Craniocervical Junction

223

(1)

Pathology of Penetrating Injury

224

(1)

Closed Cord Injury

225

(1)

Biomechanical Aspects

225

(1)

Clinical Features

225

(1)

Neuropathology

226

(1)

Contusional Injury of the Cord

226

(3)

Compression Injury of the Cord

229

(2)

Vascular Myelopathy

231

(1)

Iatrogenic Cord Injury

231

(2)

Injury of the Cervical Spine

233

(8)

Biomechanical Features

233

(1)

Direct Injury

233

(1)

Indirect Injury

234

(1)

Indirect (``Whiplash'') Injury

234

(1)

Chiropractic Manipulation

235

(1)

Bibliography

236

(1)

References

236

(5)

Injuries of Peripheral Nerves

241

(4)

Anatomy

241

(1)

Types of Morphological Reactions

242

(1)

Wallerian Degeneration

242

(1)

Retrograde Reaction (Axonal Degeneration)

242

(1)

Remote Effects

242

(1)

Edema

243

(1)

Regeneration

243

(1)

Types of Injury

243

(2)

Injuries by Compression and Percussion

243

(1)

Injuries by Traction and Elongation

243

(1)

Injuries by Transection

244

(1)

Bibliography

244

(1)

References

244

(1)

Special Physical Trauma

245

(26)

Thermal Trauma

245

(9)

Hypothermia

246

(1)

Incidence

246

(1)

Pathophysiology

246

(1)

Clinical Features

247

(1)

Neuropathology

248

(1)

Hyperthermia

248

(1)

Incidence

248

(1)

Pathophysiology

249

(1)

Clinical Features and Neuropathology

249

(1)

Heat Exhaustion

250

(1)

Sunstroke (Insolation)

250

(1)

Heatstroke

250

(1)

Trauma by Fire and Burns

251

(1)

Incidence

251

(1)

Clinical Features

251

(1)

Neuropathology

251

(3)

Electrical Trauma

254

(2)

Incidence

254

(1)

Clinical Features

254

(1)

Pathogenesis

255

(1)

Neuropathology

255

(1)

Electric Shock Devices

256

(1)

Electromagnetic Radiation

256

(1)

Lightning Trauma

256

(1)

Incidence

256

(1)

Clinical Features

256

(1)

Neuropathology

257

(1)

Irradiation Trauma

257

(2)

Pathogenesis

257

(1)

Types of CNS Reaction

258

(1)

Acute Radiation Injury

258

(1)

Radiation Necrosis

258

(1)

Transitory Radiation Myelopathy

259

(1)

Radiation Neuropathy

259

(1)

Early Delayed Reaction

259

(1)

Chronic Radiation Injury

259

(1)

Acute Onset

259

(1)

Chronic Progressive Injury

259

(1)

Special Mechanical Trauma

259

(12)

Ultrasound Injury

259

(1)

Pressure Injury

260

(1)

Barotrauma

260

(1)

Toxicity of Hyperbaric Gases

261

(1)

Decompression Sickness (DCS)

261

(1)

Incidence

261

(1)

Pathophysiology

261

(1)

Clinical Features

261

(1)

Neuropathology

262

(1)

Gas Embolism

262

(1)

Pathophysiology and Clinical Features

262

(1)

Neuropathology

263

(1)

High-Altitude Illness

263

(1)

Incidence

263

(1)

Clinical Features and Pathophysiology

263

(1)

Pathology and Neuropathology

264

(1)

Bibliography

264

(1)

References

264

(7)

III Ischemia and Asphyxia

271

(60)

Hypoxia, Ischemia (Hypoglycemia)

273

(20)

Basic Principles

273

(2)

Metabolic Disturbances

275

(1)

Hypoxia

276

(4)

High-Altitude Mountaineering

277

(1)

Respiratory Disease

278

(1)

Anemic Hypoxia

279

(1)

Histotoxic Hypoxia

279

(1)

Neuropathology

279

(1)

Ischemia

280

(6)

Pathophysiology

280

(1)

Neuropathology

281

(1)

Cerebral Cortex

281

(1)

Hippocampus

282

(2)

Basal Ganglia

284

(1)

Brain Stem

284

(1)

Cerebellum

285

(1)

Spinal Cord

285

(1)

White Matter Lesions (Leukoencephalopathy)

286

(1)

Hypoglycemia

286

(7)

Neuropathology

287

(1)

Bibliography

288

(1)

References

288

(5)

Forensic Types of Ischemia and Asphyxia

293

(26)

Suffocation

294

(3)

Environmental Suffocation

294

(1)

Smothering, Choking, and Gagging

295

(1)

Drowning

295

(1)

Mechanical Asphyxia

296

(1)

Neuropathology of Suffocation

296

(1)

Acute Death after Suffocation

296

(1)

Delayed Death after Suffocation

296

(1)

Strangulation

297

(4)

Hanging

297

(1)

Ligature Strangulation

298

(1)

Manual Strangulation

298

(1)

Neuropathology of Strangulation

298

(1)

Acute Death after Strangulation

299

(1)

Delayed Death after Strangulation

299

(1)

Cervical Spine and Strangulation

300

(1)

Time Course of Ischemia

301

(9)

Macroscopic Findings

301

(1)

Edema

301

(2)

Microthrombosis and Fibrin Deposition

303

(1)

Neurons

303

(2)

Neuronal Proteins

305

(1)

Astrocytes

306

(1)

Polymorphonuclear Leukocytes

307

(1)

Mononuclear Phagocytes/Microglia

307

(1)

Mesenchymal Reaction

308

(1)

Cytokines

308

(1)

Enzymes

309

(1)

Clinical Features of Acute Asphyxia

310

(1)

Transient Ischemia

311

(1)

Selective Neuronal Necrosis

312

(1)

Apallic Syndrome

312

(1)

Ethical Implications

312

(7)

Bibliography

313

(1)

References

313

(6)

Permanent Global Ischemia

319

(12)

Classification

319

(1)

Pathophysiology

319

(2)

Clinical Features

321

(1)

Neuropathology

321

(2)

Gross Examination

321

(1)

Microscopic Examination

322

(1)

Forensic Implications

323

(8)

Respirator Brain and/or Postmortem Autolysis

323

(2)

Declaration of Death

325

(1)

Time of Brain Death

326

(1)

Time of Causal Event Leading to Brain Death

327

(1)

Morphological Statement of Intracranial Circulatory Arrest

328

(1)

Bibliography

328

(1)

References

328

(3)

IV Intoxication

331

(74)

Introductory Remarks

333

(6)

Biological Principles

333

(2)

Toxic Encephalopathy

335

(1)

Toxic Neuropathy/Polyneuropathy

336

(3)

Bibliography

337

(1)

References

337

(2)

Specific Types of Neurotoxins

339

(32)

Metals and Metallic Compounds

339

(8)

Aluminum (Al)

339

(2)

Arsenic (As)

341

(1)

Inorganic Arsenicals

341

(1)

Organic Arsenicals

341

(1)

Bismuth (Bi)

341

(1)

Cadmium (Cd)

342

(1)

Gold (Au)

342

(1)

Lead (Pb)

342

(1)

Inorganic Lead Compounds

342

(1)

Organic Lead Compounds

343

(1)

Lithium (Li)

343

(1)

Manganese (Mn)

344

(1)

Mercury (Hg)

344

(1)

Elementary Mercury and Inorganic Mercury Compounds

344

(1)

Organic Mercury Compounds

344

(1)

Platinum (Pt)

345

(1)

Thallium (Tl)

346

(1)

Tin (Sn) and Tin Compounds

346

(1)

Triethyltin

346

(1)

Trimethyltin

346

(1)

Non-Metallic Inorganic Neurotoxins

347

(1)

Phosphorus (P) and Phosphorous Compounds

347

(1)

Sulfur (S)

347

(1)

Carbon Disulfide

347

(1)

Tellurium (Te)

347

(1)

Gases

347

(6)

Carbon Monoxide (CO)

347

(2)

Acute Intoxication

349

(1)

Intermittent Exposure

350

(1)

Chronic Intoxication

351

(1)

Cyanides and Cyanide Compounds

351

(1)

Hydrogen Sulfide (H2S)

352

(1)

Nitrous Gases and Nitrites

352

(1)

Oxygen (O2)

352

(1)

Industrial and Environmental Toxins

353

(3)

Acrylamide

353

(1)

Aliphatic Hydrocarbons

353

(1)

Halogenated Hydrocarbons

353

(1)

Methyl Chloride

353

(1)

Trichloroethylene

353

(1)

Chlorinated Cyclic Hydrocarbons

354

(1)

Hexachlorophene (HCP)

354

(1)

Lindane

354

(1)

Methyl Alcohol (Methanol)

354

(1)

Organophosphorus Compounds

355

(1)

Toxic Oil

356

(1)

Nerve Agents

356

(1)

Drugs and Pharmaceutical Products

357

(3)

Sedatives, Hypnotics and Analgesics

357

(1)

Antiprotozoal Agents

358

(1)

Chloroquine

358

(1)

Clioquinol

358

(1)

Cytostatics and Antituberculous Agents

359

(1)

Methotrexate

359

(1)

Vincristine, Vinblastine

359

(1)

Isoniacid

360

(1)

Biological Toxins

360

(11)

Plants

360

(2)

Animals

362

(1)

Microorganisms

362

(1)

Botulinum Toxin

362

(1)

Tetanospasmin

362

(1)

Diphtheria Toxin

363

(1)

Anthrax

363

(1)

Bibliography

363

(1)

References

363

(8)

Alcohol, Organic Solvents, and Aerosols

371

(20)

Epidemiology

371

(1)

Metabolism, Kinetics, and Causes of Death

372

(1)

Pharmacology

373

(1)

Clinical Features

374

(1)

Acute Intoxication

374

(1)

Chronic Intoxication (Alcoholism)

374

(1)

Neuropathology

375

(8)

Acute Intoxication

375

(1)

Chronic Intoxication

375

(1)

Diffuse Brain Alterations

376

(2)

Cerebellar Atrophy

378

(1)

Wernicke -- Korsakoff Syndrome

378

(1)

Central Pontine Myelinolysis

379

(1)

Marchiafava -- Bignami Syndrome

380

(1)

Pellagra

380

(1)

Alcoholic Myelopathy

380

(1)

Neuropathy of the Autonomic Nervous System

380

(1)

Neuropathy/Polyneuropathy

380

(1)

Myopathy

381

(1)

Secondary Pathologic Alterations

381

(2)

Disulfiram Treatment

383

(1)

Alcoholic Fetopathy and Embryopathy

383

(1)

Organic Solvents and Aerosol

384

(7)

Bibliography

385

(1)

References

385

(6)

Illegal Drugs and Drug Dependence

391

(14)

Epidemiological and Social Data

391

(1)

Cannabis

392

(1)

Hallucinogens and Entactogens

392

(2)

Mescaline

393

(1)

Lysergic Acid Diethylamide (LSD)

393

(1)

Amphetamine Substitutes

393

(1)

MDMA (3,4-methylenedioxmeth-amphetamine)

393

(1)

MDEA (3,4-methylenedioxyeth-amphetamine)

394

(1)

Other Agents

394

(1)

Narcotics: Opium and Opioids

394

(4)

Basic Principles

394

(1)

Epidemiology

394

(1)

Pathophysiology

395

(1)

Neuropathology

395

(2)

Morphine

397

(1)

Heroin

397

(1)

Codeine

397

(1)

Dihydrocodeine (DHC)

398

(1)

Methadone

398

(1)

Other Narcotic Agents

398

(1)

Stimulants

398

(7)

Cocaine

398

(1)

Cocaine Freebase: Crack

399

(1)

Amphetamine and Methamphetamine (Speed)

399

(1)

Caffeine

400

(1)

Ephedrine

400

(1)

Khat

400

(1)

Bibliography

401

(1)

References

401

(4)

V Pediatric Neuropathology

405

(118)

Basic Principles

407

(18)

Epidemiology

407

(1)

Injuries During the Perinatal Period

407

(1)

Acquired Postnatal Injury

408

(1)

Developmental Neuroanatomy

408

(4)

The Coverings

408

(3)

The Brain

411

(1)

Autopsy Findings

412

(2)

Head and Cranial Contents

413

(1)

Cervical Spine

413

(1)

Ears and Mastoids

414

(1)

Eyes

414

(1)

Microscopic Examination: Cell Reaction

414

(1)

Postmortem Biochemistry

415

(1)

Diffuse Cerebral Swelling

415

(2)

Hyperemia

416

(1)

Edema

416

(1)

Hydrocephalus

416

(1)

Forensic Aspects (Expert Witness)

417

(8)

Medical Malpractice

417

(2)

Physical Abuse

419

(1)

Ethical Aspects

419

(1)

Bibliography

420

(1)

References

420

(5)

Fetal Neuropathology

425

(8)

Malformations

425

(2)

Hypoxic -- Ischemic Encephalopathy

427

(2)

Neuropathology

428

(1)

Intoxication

429

(2)

Cocaine

431

(1)

Heroin

431

(1)

Infection

431

(2)

Bibliography

432

(1)

References

432

(1)

Perinatal CNS Injury

433

(18)

Ischemic--Asphyxiant Injury

434

(7)

Causes of Oxygen Depletion

434

(1)

Ischemic Cell Injury

435

(1)

Pathophysiology

435

(1)

Cytopathology

436

(1)

Neuropathology

436

(1)

Qualitative Differences

437

(2)

Topographical Differences

439

(2)

Dating of Asphyxiant Injury

441

(1)

Mechanical Injury (Birth Injury)

441

(5)

Extracranial Hemorrhages

441

(2)

Skull Fracture

443

(1)

Intracranial Hemorrhages

443

(1)

Epidural Hemorrhage (EDH)

443

(1)

Subdural Hemorrhage (SDH)

443

(1)

Subarachnoid Hemorrhage (SAH)

444

(1)

Intraparenchymal Hemorrhage

444

(1)

Dating of Intracerebral Hemorrhages in Immature Infants

445

(1)

Spinal Cord Injury

445

(1)

Peripheral Nerve Injury

445

(1)

Venous Sinus Thrombosis

446

(1)

Late Sequelae of Perinatal Brain Injury

447

(4)

Bibliography

447

(1)

References

447

(4)

Postnatal Natural CNS Death

451

(20)

Metabolic Diseases

451

(5)

Bilirubin Encephalopathy

452

(2)

Pathophysiology

454

(1)

Neuropathology

454

(1)

Hypoglycemic Encephalopathy

454

(1)

Pathophysiology

455

(1)

Neuropathology

455

(1)

Hemorrhagic Shock and Encephalopathy Syndrome (HSES)

455

(1)

Iron Deficiency

456

(1)

Stroke

456

(1)

Infectious Diseases

457

(2)

Bacterial Meningitis

457

(1)

Abacterial Meningoencephalitis

458

(1)

Tumor

459

(1)

Sudden Infant Death Syndrome (SIDS)

460

(11)

Definition and Incidence

460

(1)

Neuropathology and Pathophysiology

461

(1)

Primary CNS Changes

461

(2)

Perfusion Disturbance or Ischemia

463

(2)

Conclusion

465

(1)

Bibliography

465

(1)

References

465

(6)

Postnatal Mechanical Brain Injury (MBI)

471

(18)

Incidence

471

(1)

Clinical Features

472

(1)

Biomechanical Aspects and Causal Events

472

(2)

Skull Fracture

474

(4)

Growing Fracture

478

(1)

Dural Hemorrhages

478

(2)

Epidural Hemorrhage (EDH)

478

(1)

Subdural Hemorrhage (SDH)

479

(1)

Chronic Subdural Hemorrhage (SDH)

479

(1)

Subdural Hygroma

479

(1)

Subarachnoid Hemorrhage (SAH)

480

(1)

Cerebral Contusion and Laceration Injury

480

(1)

Neuropathology

481

(1)

Biomechanics

481

(1)

Clinical Features

481

(1)

Mechanical Vessel Injury

481

(1)

Secondary Alterations

481

(1)

Edema and Hypoxia

481

(1)

Inflammation

482

(1)

Late Sequelae

482

(2)

Hydrocephalus

482

(1)

Seizures

483

(1)

Spinal Cord Injury

484

(5)

Bibliography

484

(1)

References

484

(5)

Physical Abuse

489

(34)

Basic Principles

489

(4)

Sociopsychological/Forensic Considerations

489

(2)

Definition

491

(1)

Incidence

492

(1)

Types of Brain Injuries

492

(1)

Mechanically Caused Brain Injury

493

(1)

Shaken Infant Syndrome

493

(18)

Clinical Features

493

(3)

Autoptic Findings

496

(1)

Intracranial Hemorrhage

497

(1)

Retinal Hemorrhage

497

(3)

Brain Edema

500

(1)

Cervical Cord Injury: Dural Hemorrhage and Cord Lesion

500

(1)

Skull Fracture

501

(1)

Further Morphological Alterations

502

(1)

The Repeated Shaking

502

(1)

Shaking Impact Syndrome

502

(1)

``Tin-Ear'' Syndrome

502

(1)

Cause of Death

503

(1)

Clinical Outcome

503

(1)

Differential Diagnosis

504

(1)

Wounding by Birth

505

(1)

Dehydration

505

(1)

Physiotherapy in Premature Infants

506

(1)

Sudden Infant Death Syndrome (SIDS)

506

(1)

Resuscitation

506

(1)

``Rebleed'' of Chronic Subdural Hematoma

507

(1)

Shaking versus Fall

507

(1)

Epidemiologic Evaluation

507

(1)

Biomechanical Aspects

508

(2)

Conclusion

510

(1)

Asphyxiant Brain Injury

511

(2)

Types of Violence

511

(1)

Compression of the Chest

511

(1)

Drowning

512

(1)

Neuropathology

513

(1)

Toxic Brain Injury

513

(1)

Incidence

513

(1)

Clinical Features and Neuropathology

514

(1)

Obligations of an Expert Witness

514

(9)

Bibliography

515

(1)

References

515

(8)

IV Clinical Neuropathology

523

(118)

Basic Principles

525

(4)

Sudden, Unexpected Death

525

(2)

Definition

525

(1)

Epidemiology

526

(1)

Classification

526

(1)

Neuronal-Mediated Death

526

(1)

Death Associated with Vascular Diseases

527

(1)

Death Associated with Inflammatory Diseases

527

(1)

Further Cerebral Diseases of Forensic Significance

527

(2)

Bibliography

528

(1)

References

528

(1)

Seizures and Epilepsy

529

(12)

Classification

529

(2)

Clinical Features

531

(1)

Etiology of Symptomatic Epilepsy

531

(1)

Pathogenesis

532

(1)

Pathophysiology

532

(1)

Epidemiology

532

(1)

Neuropathology

533

(2)

Hippocampal Pathology

534

(1)

Temporal Lobe Epilepsy

535

(1)

Myoclonic Epilepsy

535

(1)

Status Epilepticus

535

(1)

Cause of Death

535

(2)

Sudden Unexpected Death in Epilepsy (SUDEP)

536

(1)

Risk Factors

536

(1)

Pathogenetic Considerations

536

(1)

Diagnosis of SUDEP

537

(1)

Additional Forensic Implications

537

(4)

Bibliography

537

(1)

References

537

(4)

Vascular Diseases

541

(40)

Physiology of the Cerebral Circulation

542

(1)

Anatomy of Cerebral Vessels

543

(1)

Pathology of Cerebral Arteries

543

(12)

Cerebral Atherosclerosis

543

(2)

Brain Calcinosis

545

(1)

Cerebral Thromboembolism

546

(1)

Hypertensive Angiopathy

546

(2)

Lacunar Infarcts

548

(1)

Amyloid Angiopathy

548

(1)

Cystic Medial Necrosis

549

(1)

Aneurysms

549

(1)

Saccular (Fusiform) Aneurysm

550

(2)

Dissecting Aneurysm

552

(1)

Infectious (Mycotic) Aneurysm

553

(1)

Mechanically Induced Aneurysm

553

(1)

Inflammatory Vessel Disease (Vasculitis)

553

(1)

Non-Infectious Primary CNS Vasculitis

553

(1)

Infectious Vascular Diseases

554

(1)

Pathology of Cerebral Veins

555

(2)

Cerebral Venous Thrombosis

555

(2)

Vascular Malformations

557

(1)

Cavernous Angioma

557

(1)

Capillary Angioma

557

(1)

Venous Angioma

557

(1)

Arteriovenous Malformation

558

(1)

Von Hippel--Lindau Hemangioblastoma

558

(1)

Tumor-Induced Stroke

558

(3)

Thrombosis and Embolism

559

(1)

Tumor Vessels and Hemorrhage

559

(2)

Extracerebral Causes of Stroke

561

(3)

Coagulopathy, Hemostatic Disorder, Cerebral Thrombosis

561

(1)

Cerebral Embolism

561

(1)

Circulatory Disturbance

561

(3)

Illegal Drugs

564

(1)

Ischemic Stroke: Infarction

564

(5)

Classification of Cerebral Ischemia

565

(1)

Clinical Features of Transient and Permanent Focal Ischemia

565

(1)

Neuropathology

566

(3)

Spontaneous Intracerebral Hemorrhage

569

(4)

Incidence

569

(1)

Clinical Features

569

(2)

Neuropathology

571

(1)

Causes of Spontaneous Intracerebral Hemorrhage

572

(1)

Vascular Diseases of the Spinal Cord

573

(1)

Anatomy of the Spinal Vessels

573

(1)

Pathology of the Spinal Vessels

573

(1)

Forensic Aspects of Stroke

574

(7)

Bibliography

574

(1)

References

574

(7)

Inflammatory Diseases

581

(24)

Bacterial CNS Diseases

582

(11)

Purulent Leptomeningitis

582

(2)

Neuropathology

584

(1)

Late Complications

585

(1)

Neonatal Meningitis

585

(1)

Meningococcal Meningitis

585

(1)

Haemophilus Influenzae Meningitis

585

(1)

Pneumococcal Meningitis

585

(1)

Epidural Abscess

585

(1)

Subdural Abscess and/or Empyema

586

(1)

Brain Abscess

586

(1)

Tuberculous Brain Infection

587

(1)

Septic Encephalopathy

587

(3)

Abacterial CNS Diseases

590

(1)

Classification

590

(1)

Pathogenesis

591

(1)

Clinical Features

591

(1)

Neuropathology

591

(2)

AIDS and the Nervous System

593

(2)

Primary HIV-Associated Nervous System Infection

593

(1)

HIV Encephalopathy (Subacute Dementia Encephalopathy)

593

(1)

HIV Myelopathy

593

(1)

HIV Neuropathy

594

(1)

Secondary HIV-Associated NS Infection

594

(1)

Transmissible Spongiform Encephalopathies

595

(1)

Non-Infectious Inflammatory Diseases

596

(9)

Acute Hemorrhagic Leukoencephalitis (Hurst's Disease)

596

(1)

Acute Demyelinating Disease

597

(1)

Chronic Demyelinating Disease: Multiple Sclerosis

598

(3)

Bibliography

601

(1)

References

601

(4)

Nutritional and Metabolic Insults

605

(14)

Starvation and Malnutrition

606

(2)

Protein Deficiency

606

(1)

Vitamin Deficiencies

606

(1)

Disturbances of Glucose Metabolism

607

(1)

Hypoglycemic Encephalopathy

607

(1)

Hyperglycemia

608

(1)

Diagnosis

608

(1)

Dissociation of Water and Electrolyte Balance

608

(3)

Dehydration

608

(1)

Hypernatremia

609

(1)

Hyponatremia and Water Intoxication

609

(1)

Hyponatremia and Central Pontine Myelinolysis

610

(1)

Hepatic Encephalopathy

611

(1)

Fulminant Hepatic Failure

611

(1)

Chronic Liver Disease and Portal-Systemic Bypass

611

(1)

Familial Hepatolenticular Degeneration (Wilson's Disease)

612

(1)

Reye's Syndrome

612

(1)

Uremic Encephalopathy

612

(7)

Dialysis Encephalopathy

613

(1)

Bibliography

614

(1)

References

614

(5)

Aging and Brain Pathology

619

(22)

Basic Principles

619

(2)

Biology of Aging

619

(1)

Neurobiology of Aging

620

(1)

Dementia and Delirium

620

(1)

Classification of Age-Dependent Dementias

621

(1)

Morphology of the Aging Brain

621

(4)

Macroscopic Alterations

621

(1)

Microscopic Alterations

622

(1)

Neurofibrillary Tangles

623

(2)

Senile Plaques

625

(1)

Pathology of the Aging Brain

625

(16)

Alzheimer's Disease (AD)

626

(1)

Clinical Features

626

(1)

Neuropathology and Diagnostic Criteria

627

(2)

Pathogenesis

629

(1)

Neurofibrillary Tangles and Dementia

630

(1)

Dementia Pugilistica

630

(1)

Dementia in Parkinson's Disease (PD)

631

(1)

Lewy Body Dementia

632

(1)

Frontotemporal Dementia (Pick's Disease)

632

(2)

Vascular Dementia

634

(2)

Bibliography

636

(1)

References

636

(5)

Subject Index

641

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Forensic Neuropathology And Associated Neurology

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