NCJ Number
215154
Journal
Journal of Forensic Sciences Volume: 51 Issue: 4 Dated: July 2006 Pages: 880-887
Date Published
July 2006
Length
8 pages
Annotation
This paper reviews the state-of-the-art of recent scientific discussions of the pathophysiology and morphology of the central nervous system (CNS) under hypoxic/ischemic conditions and provides relevant theoretical and practical advice to forensic pathologists.
Abstract
Ischemia is characterized by a reduction or stop of the general or regional blood flow to the brain, resulting in irreversible neuronal destruction. Hypoxia leads to an increase in cerebral blood flow, usually resulting in a reversible breakdown of neuronal functions. Currently there are few data on the very early neuropathological changes due to acute anoxia/ischemia or hypoxia/hypoxemia. Microscopic findings for the brain that are associated with death by hanging are described by Jacob and colleagues; but most analysts assume that the observed nerve cell changes are not typical. These rare observations are challenged by an extensive literature that describes consistent structural neuronal changes, demonstrated by routine staining techniques, only after survival times of at least 3 to 7 hours. These data lead to the conclusion that early structural changes constitute a questionable "proof" of anoxia when examining the vitality of nerve cells. The vitality and further structural changes in the central nervous system depend on survival time and the course of the reactive modification. Such observations may aid in classifying the survival time of the event itself. 3 tables, 6 figures, and 62 references