PMID- 11074174
OWN - NLM
STAT- MEDLINE
DCOM- 20001228
LR  - 20190831
IS  - 0379-0738 (Print)
IS  - 0379-0738 (Linking)
VI  - 115
IP  - 3
DP  - 2001 Jan 15
TI  - Brain injury after survived gunshot to the head: reactive alterations at sites 
      remote from the missile track.
PG  - 189-97
AB  - Gunshot wounds to the brain usually lead to acute respiratory arrest or death 
      after a brief survival period, even in cases involving only slight direct tissue 
      damage. It can be assumed therefore that the damage extends beyond the zone of 
      recognizable destruction and hemorrhages. To determine the true extent of the 
      tissue injury resulting from gunshot wounds to the brain, we carried out 
      microscopic investigations for reactive changes (emigration of leukocytes and 
      macrophages, axonal expression of beta-amyloid precursor protein (beta-APP) in 10 
      cases of gunshot wound to the narrow channel of the brain with survival times 
      >2h. Demonstration of leukocytes expressing naphthol AS-D chloroacetate esterase 
      activity in the brain tissue at the border of the missile track established the 
      vitality of the gunshot effect. The presence of macrophages (CD68-epitope) 
      allowed demarcation of a 1-2mm wide necrotic zone around the permanent cavity. 
      Within this zone and beyond, beta-APP showed an initial increase followed by a 
      decline in the number of injured axons. Three types of beta-APP positive staining 
      could be differentiated. In the immediate vicinity of the missile track beta-APP 
      positive neurons were present at a distance of 2-4mm from the margin of the 
      permanent cavity (type 1) as a result of primary injured neuronal tissue by the 
      gunshot itself. At longer distances from the narrow channel and the permanent 
      cavity single beta-APP positive axons or axon fragments and two additional types 
      were found; type 2 shows a parallel, wave-like arrangement of the damaged fibers, 
      which suggests that the injury was produced by mechanical acceleration of the 
      brain tissue created by the energy the projectile expended within the brain; 
      irregular aggregation of beta-APP positive axons or axon fragments within a local 
      edema represents type 3, which may be attributed to secondary ischemia or edema.
FAU - Oehmichen, M
AU  - Oehmichen M
AD  - Department of Legal Medicine, Medical University of Lubeck, Kahlhorststrasse 
      31-35, D-23562, Lubeck, Germany. oehmich@rmed.mu-luebeck.de
FAU - Meissner, C
AU  - Meissner C
FAU - Konig, H G
AU  - Konig HG
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Ireland
TA  - Forensic Sci Int
JT  - Forensic science international
JID - 7902034
RN  - 0 (Amyloid beta-Protein Precursor)
RN  - 0 (Antigens, CD)
RN  - 0 (Antigens, Differentiation, Myelomonocytic)
RN  - 0 (CD68 antigen, human)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amyloid beta-Protein Precursor/analysis
MH  - Antigens, CD/analysis
MH  - Antigens, Differentiation, Myelomonocytic/analysis
MH  - Autopsy/*methods
MH  - Biomechanical Phenomena
MH  - Biopsy/*methods
MH  - Brain Death
MH  - Brain Injuries/*complications/*pathology/therapy
MH  - Diffuse Axonal Injury/*etiology/*pathology
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Leukocytes/pathology
MH  - Macrophages/pathology
MH  - Male
MH  - Middle Aged
MH  - Necrosis
MH  - Respiration, Artificial
MH  - Time Factors
MH  - Wounds, Gunshot/*complications/*pathology/therapy
EDAT- 2000/11/14 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/11/14 11:00
PHST- 2000/11/14 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/11/14 11:00 [entrez]
AID - S0379073800003352 [pii]
AID - 10.1016/s0379-0738(00)00335-2 [doi]
PST - ppublish
SO  - Forensic Sci Int. 2001 Jan 15;115(3):189-97. doi: 10.1016/s0379-0738(00)00335-2.