Forensic Neuropathology (Hodder Arnold Publication)
Language: English
Pages: 228
ISBN: 0340700041
Format: PDF / Kindle (mobi) / ePub
The field of neuropathology is often considered to be one of the most complex areas of pathology. General pathologists as well as forensic pathologists, neuropathologists and paediatric pathologists are frequently presented with complex forensic neuropathology issues, and significant advances in the understanding of head injury, as well as other brain pathology, have highlighted the importance of forensic neuropathology within the medico–legal setting. It is in this climate that Forensic Neuropathology comes into its own.
The internationally recognised editor and main author, Helen L. Whitwell, is Professor of Forensic Pathology at Sheffield University, Sheffield, UK, and works jointly as a forensic pathologist and as a neuropathologist. Her co-authors are selected from neuropathological, clinical and forensic practice in the UK and Europe. Forensic Neuropathology is written by experts for specialists and trainees alike and succeeds in addressing the concerns of the forensic pathologist and those of the neuropathologist by tackling the overlapping problems that arise during the postmortem examination and subsequent legal proceedings.
The book takes a practical approach and the text is complemented by a wide range of colour illustrations, demonstrating examples and techniques. Subjects covered include anatomy, traumatic brain injury, neurotoxicology and the legal issues that those working in this field need to consider, enabling the reader to make clear, confident decisions.
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compound the problem. Evidence of both recent and old head injury is common in chronic alcoholism. Wernicke’s encephalopathy MACROSCOPIC EXAMINATION It is important to remember that microscopic examination is mandatory because the brain may appear macroscopically normal in up to 25 per cent of cases (Harper 1983). Areas of haemorrhagic necrosis are seen in the mamillary bodies (Figure 14.1) and in the hypothalamic region surrounding the third ventricle. Similar lesions may be seen in the
disorders (Lampl and Yazdi 2002), although it is most commonly seen in people with chronic alcoholism. The disorder is thought to result from electrolyte 170 ■ Alcohol, drugs and toxins Figure 14.4 Marked superior vermal atrophy secondary to chronic alcoholism. The vermal section on the left is from an age-matched control and shows only very minor superior vermal atrophy. The vermal section on the right, from someone who is alcoholic, by contrast shows marked atrophy. Clinically this
destroyed in the process of analysis or disposed of immediately afterwards. However, it is well worth looking for samples that have been sent to the laboratory; although these too can be ephemeral, samples sent for immunology or cross-matching can be kept for weeks rather than days. They are always worth looking for in appropriate circumstances, particularly if they were collected before, e.g. intensive therapy unit (ITU) admission. The collection of samples post mortem comes next. The blood
the pattern of tattooing and soot staining will depend on a number of factors including type of weapon and ammunition, length of barrel and distance fired from the body. With longer barrels, soot deposition occurs for a greater distance from the target than a shorter barrel. In general soot and powder deposition can be seen up to a Classification of injuries ■ 45 Figure 3.21 Entrance gunshot wound with powder tattooing. Figure 3.22 Atypical entrance gunshot wound of occiput. range of 20–30 cm
found but a proportion progress to coma and death. The pathology shows diffuse generalized brain swelling with little evidence of brain injury. It appears that the diffuse swelling may, in a number of these cases, be related to vascular congestion with hyperaemia rather than true cerebral oedema (Bruce et al. 1981, Sakas et al. 1997). A number of these cases follow a benign course (Snoek et al. 1984) and the syndrome can occur with relatively trivial trauma. More recently, it has been reported