Introduction/Objective. The diffuse axonal injury has a very important place
in clinical and forensic aspects of neurotraumatology. A special challenge is
proving it in situations of short survival (less than two hours) after a
craniocerebral injury. The aim of this study was to determine the efficacy of
beta-amyloid precursor protein (?APP) immunohistochemical staining in
postmortem diagnosis of axonal injuries in head injury survival shorter than
two hours, its expression and distribution through the brain tissue of the
deceased. Methods. 36 adult fatalities, both sexes, injured by
acceleration-deceleration mechanisms were divided into two groups: died up to
two hours and died more than two hours after the injury. Immunostaining of
brain tissue samples (frontal parasagittal white mass, genu and splenium of
the corpus callosum and rostral pons) was used to register ?APP positivity.
Data were processed by methods of descriptive and inferential nonparametric
statistics, and p < 0.05 was considered statistically significant. Results.
The ?APP immunopositivity was shown in 88.9% of cases (82.3% of ? two hours
group vs. 94.7% of > two hours group). ?APP expression was enhanced towards
the posterior structures of the brain. The shortest survival period with
detected ?APP immunopositivity was 20-25 minutes, in three cases. There was
an association of ?APP expression in the brainstem and
interhemispheric/paramesencephalic subarachnoid hemorrhage (p = 0.035).
Conclusion. ?APP immunohistochemical staining is effective in proving diffuse
axonal injury in casualties that survived less than half an hour.
Interhemispheric/paramesencephalic subarachnoid hemorrhage may indicate a
more severe form of axonal injury.
Expression and distribution of β amyloid precursor protein immunomarkers in the detection of diffuse axonal injury
