ABSTRACT
Objective To summarize the general characteristics and identification considerations of appraisal of post-traumatic epilepsy （PTE） in forensic clinical expertise. Methods Descriptive statistics were made on the general situations （age and sex）, injury sites, PTE grading, clinical manifestations and blood drug concentrations of 30 cases of PTE. Chi-square test was performed on the differences of sex composition, age group incidences, injury sites, clinical manifestations and PTE grading. Fisher's exact probability method was used to test the differences in clinical manifestations and PTE grading of each site and the differences in PTE grading of different clinical manifestations. Results PTE occurred more frequently among 21 to 40 year olds, more in males than in females, and more frequently in the temporal lobe and frontal lobe. The clinical manifestations were mostly partial seizures and the PTE grading was mostly mild PTE. There were no statistical significance in the differences in distribution of clinical manifestations and PTE grading of injury sites （P>0.05）. The difference in the PTE grading of different clinical manifestations had no statistical significance （P>0.05）. The blood drug concentration of the three identified people did not reach the effective concentration, which affected the final identification opinion. Conclusion In the identification of PTE, in addition to strictly grasping the necessary factors of identification, such as the history of craniocerebral trauma, and epileptic seizures, it is also suggested that attention should be paid to the detection of blood drug concentration. Overall analysis and comprehensive evaluation should be made.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Craniocerebral Trauma , Epilepsy, Post-Traumatic , Incidence , Retrospective StudiesABSTRACT
Post traumatic epilepsy （PTE） refers to the epileptic seizures after traumatic brain injury. Organic damage can be found by imaging examination, and abnormal electroencephalogram can be detected via electroencephalogram examination which has the similar location of the brain injury. PTE has the characteristics of low incidence, absence of case reports, and easy to exaggerate the state of illness, which add difficulties to the forensic identification. This paper reviews the status of epidemiology, pathogenesis, clinical treatment and forensic identification for PTE.
Subject(s)
Humans , Brain Injuries, Traumatic/physiopathology , Electroencephalography , Epilepsy , Epilepsy, Post-Traumatic/pathology , Forensic Pathology , IncidenceABSTRACT
OBJECTIVE@#To study the correlation of daily living activities with location and severity of trau- matic brain injury (TBI) and to provide a theoretical basis for improving the accuracy of expert opinion.@*METHODS@#Five hundred and one cases of patients with TBI were selected. Detailed records included following: pre-injury situation, location and severity of injury, treatment and education. Daily living activi- ties scale (Barthel index) was applied to test the subjects' daily living activities. The relevance among location and severity of TBI and Barthel index was statistically analyzed.@*RESULTS@#In mild TBI group, there was no significant difference in Barthel index among each location (P>0.05). In moderate TBI group, there were significant differences in Barthel index between subarachnoid hemorrhage and cerebral lobe injury, also between parietal, occipital lobes injury and frontal lobe injury, parietal, occipital lobes injury and temporal lobe (P<0.05), respectively, whereas no significant difference in Barthel index between frontal lobe injury and temporal lobe injury (P>0.05). In severe TBI, there were significant differences in Barthel index between every two different locations (P<0.05).@*CONCLUSION@#There is some correlation between the location of TBI and Barthel index, which provides an important reference value for analyzing and determining daily living activities after TBI.
Subject(s)
Adult , Female , Humans , Male , Activities of Daily Living , Brain Injuries/rehabilitation , Outcome Assessment, Health Care , Trauma Severity IndicesABSTRACT
Diagnosis of nervous system injury is one of the most difficult issues in medical-legal practice. Nowadays, the activation of NF-kappaB has been studied by many researchers in order to find objective evidence and indicators to calculate the injury time and to diagnose the severity of brain injury for forensic practice. It was reviewed that the advances and problems of NF-kappaB and its correlation with nervous system injury and diseases, such as cerebral ischemia, traumatic brain injury, Alzheimer's disease and amyotrophic lateral sclerosis.
Subject(s)
Humans , Alzheimer Disease/metabolism , Brain Injuries/metabolism , Brain Ischemia/metabolism , Forensic Medicine , NF-kappa B/metabolism , Reperfusion Injury/metabolism , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate changes of autophagy after traumatic brain injury (TBI) and its possible role.</p><p><b>METHODS</b>Rat TBI model was established by controlled cortical injury system. Autophagic double membrane structure was detected by transmission electronic microscope. Microtubule-associated protein 1 light chain 3 (LC3) and Beclin 1 were also used to investigate the activation of autophagy post-TBI. Double labeling with LC3 and caspase-3, or Beclin 1 and Fluoro-Jade to show the relationship between autophagy and apoptosis or neuron degeneration after TBI.</p><p><b>RESULTS</b>An increase of autophagic double membrane structure was observed in early stage (1 h), and the increase lasted for at least 32 d post-TBI. LC3 and Beclin 1 proteins also began to elevate at 1 h time point post-TBI in neurons, 3 d later in astrocytes, and peaked at about 8 d post-TBI. In both cell types, LC3 and Beclin 1 maintained at a high level until 32 d post-TBI. Most LC3 and Beclin 1 positive cells were near the side (including hippocampus), but not in the core of the injury. In addition, in the periphery of the injury site, not all caspase-3 positive (+) cells merged with LC3 (+) cells post-TBI; In hippocampal area, almost all Beclin 1 (+) neurons did not merge with Fluoro-Jade (+) neurons from 1 h to 48 h post-TBI.</p><p><b>CONCLUSION</b>Autophagy is activated and might protect neurons from degeneration at early stage post-TBI and play a continuous role afterwards in eliminating aberrant cell components.</p>
Subject(s)
Animals , Male , Rats , Apoptosis Regulatory Proteins , Metabolism , Astrocytes , Metabolism , Pathology , Autophagy , Beclin-1 , Brain , Metabolism , Pathology , Brain Injuries , Metabolism , Pathology , Caspase 3 , Metabolism , Cell Membrane , Metabolism , Pathology , Cytoprotection , Disease Models, Animal , Fluoresceins , Fluorescent Antibody Technique , Hippocampus , Metabolism , Pathology , Microscopy, Electron, Transmission , Microtubule-Associated Proteins , Metabolism , Nerve Degeneration , Metabolism , Pathology , Neurons , Metabolism , Pathology , Organic Chemicals , Rats, Sprague-Dawley , Time Factors , Up-RegulationABSTRACT
OBJECTIVE@#To study the expression of cathepsin-B and -D in different time point after traumatic brain injury.@*METHODS@#Traumatic brain injury (TBI) model was established on rats, cathepsin-B and cathepsin-D immunofluorescence staining and confocal microscope analysis were performed. Positive cells were counted by confocal microscope and image analysis techniques were used to determine the morphological changes in each group.@*RESULTS@#Immunofluorescence staining results showed that cathepsin-B was activated 1 hour after TBI while cathepsin-D was not activated until 12hour after TBI. Both of them got to their peak during 4 to 8days, and kept a high level of activating 32days after TBI. Cathepsin-B and -D positive cells did not merge with caspase-3 positive cells until 6 h after TBI.@*CONCLUSION@#Cathepsin-B and -D could be the diagnostic markers of TBI and can estimating time course of lateral TBI. They blocked caspase-3 activation at the beginning period after TBI and started to promote cell death with caspase-3 6 h after TBI.