Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining
Accurate identification of diffuse axonal injury is important in the forensic investigation of infants who have died from traumatic brain injury. beta-Amyloid precursor protein (beta-APP) immunohistochemical staining is highly sensitive in identifying diffuse axonal injury. However, the effectivenes...
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| Veröffentlicht in: | Archives of pathology & laboratory medicine (1976) 1999-02, Vol.123 (2), p.146-151 |
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| creator | Gleckman, A M Bell, M D Evans, R J Smith, T W |
| description | Accurate identification of diffuse axonal injury is important in the forensic investigation of infants who have died from traumatic brain injury. beta-Amyloid precursor protein (beta-APP) immunohistochemical staining is highly sensitive in identifying diffuse axonal injury. However, the effectiveness of this method in brain-injured infants has not been well established. The present study was undertaken to assess the utility of beta-APP immunohistochemistry in detecting diffuse axonal injury in infants with either shaken baby syndrome or blunt head trauma.
Archival formalin-fixed, paraffin-embedded blocks from infants ( |
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Archival formalin-fixed, paraffin-embedded blocks from infants (<1 year old) with shaken baby syndrome (7 cases) and blunt head trauma (3) and blocks from 7 control cases that included nontraumatic cerebral edema (1), acute hypoxic-ischemic encephalopathy (1), and normal brain (5) were immunostained for beta-APP. A semiquantitative assessment of the severity of axonal staining was made. Corresponding hematoxylin-eosin-stained sections were examined for the presence of axonal swellings.
Immunostaining for beta-APP identified diffuse axonal injury in 5 of 7 infants with shaken baby syndrome and 2 of 3 infants with blunt head trauma. Immunoreactive axons were easily identified and were present in the majority of the sections examined. By contrast, hematoxylineosin staining revealed axonal swellings in only 3 of 7 infants with shaken baby syndrome and 1 of 3 infants with blunt head trauma. Most of these sections had few if any visible axonal swellings, which were often overlooked on initial review of the slides. No beta-APP immunoreactivity was observed in any of the 7 control cases.
Immunostaining for beta-APP can easily and reliably identify diffuse axonal injury in infants younger than 1 year and is considerably more sensitive than routine hematoxylin-eosin staining. We recommend its use in the forensic evaluation of infants with fatal craniocerebral trauma.</description><identifier>ISSN: 0003-9985</identifier><identifier>PMID: 10050789</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Amyloid beta-Protein Precursor - analysis ; Axons ; Battered Child Syndrome - pathology ; Brain - pathology ; Brain Injuries - pathology ; Child ; Child, Preschool ; Female ; Humans ; Immunohistochemistry ; Infant ; Male</subject><ispartof>Archives of pathology & laboratory medicine (1976), 1999-02, Vol.123 (2), p.146-151</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10050789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gleckman, A M</creatorcontrib><creatorcontrib>Bell, M D</creatorcontrib><creatorcontrib>Evans, R J</creatorcontrib><creatorcontrib>Smith, T W</creatorcontrib><title>Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining</title><title>Archives of pathology & laboratory medicine (1976)</title><addtitle>Arch Pathol Lab Med</addtitle><description>Accurate identification of diffuse axonal injury is important in the forensic investigation of infants who have died from traumatic brain injury. beta-Amyloid precursor protein (beta-APP) immunohistochemical staining is highly sensitive in identifying diffuse axonal injury. However, the effectiveness of this method in brain-injured infants has not been well established. The present study was undertaken to assess the utility of beta-APP immunohistochemistry in detecting diffuse axonal injury in infants with either shaken baby syndrome or blunt head trauma.
Archival formalin-fixed, paraffin-embedded blocks from infants (<1 year old) with shaken baby syndrome (7 cases) and blunt head trauma (3) and blocks from 7 control cases that included nontraumatic cerebral edema (1), acute hypoxic-ischemic encephalopathy (1), and normal brain (5) were immunostained for beta-APP. A semiquantitative assessment of the severity of axonal staining was made. Corresponding hematoxylin-eosin-stained sections were examined for the presence of axonal swellings.
Immunostaining for beta-APP identified diffuse axonal injury in 5 of 7 infants with shaken baby syndrome and 2 of 3 infants with blunt head trauma. Immunoreactive axons were easily identified and were present in the majority of the sections examined. By contrast, hematoxylineosin staining revealed axonal swellings in only 3 of 7 infants with shaken baby syndrome and 1 of 3 infants with blunt head trauma. Most of these sections had few if any visible axonal swellings, which were often overlooked on initial review of the slides. No beta-APP immunoreactivity was observed in any of the 7 control cases.
Immunostaining for beta-APP can easily and reliably identify diffuse axonal injury in infants younger than 1 year and is considerably more sensitive than routine hematoxylin-eosin staining. We recommend its use in the forensic evaluation of infants with fatal craniocerebral trauma.</description><subject>Adult</subject><subject>Amyloid beta-Protein Precursor - analysis</subject><subject>Axons</subject><subject>Battered Child Syndrome - pathology</subject><subject>Brain - pathology</subject><subject>Brain Injuries - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Infant</subject><subject>Male</subject><issn>0003-9985</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kNtKxDAQhnuhuOvqK0iuvCukTU_xTtYjLHij12WaTmyWJllzQPsuPqwRVxj452d-vhnmJFtTSlnOeVevsnPv98nysizOslVBaU3bjq-z7zslZfRI4MsamIky--iWJKkkmODJpwoTMWkohBrRhBQSDoyyAh0OLtngIGq4IWgmMAJHMmJAEZQ1ZFjIgAFy0Mts1UgODkV03rrU2YC_a7SOxk7KBysm1EokoA-gjDLvF9mphNnj5VE32dvD_ev2Kd-9PD5vb3f5oaRtyEdeNLxmtBgo7VhX0YqDlHRgJfKqQl4yaIQUbTV0jWyKkrNaDGVb80pgLRDYJrv-46ajPiL60GvlBc4zGLTR94nOC87aFLw6BuOgcewPTmlwS___T_YDO8F1Ug</recordid><startdate>19990201</startdate><enddate>19990201</enddate><creator>Gleckman, A M</creator><creator>Bell, M D</creator><creator>Evans, R J</creator><creator>Smith, T W</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19990201</creationdate><title>Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining</title><author>Gleckman, A M ; Bell, M D ; Evans, R J ; Smith, T W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p207t-d91695301b008384049aff0b32e944e923a6cfc74b86f612935cb27594ce5cea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Amyloid beta-Protein Precursor - analysis</topic><topic>Axons</topic><topic>Battered Child Syndrome - pathology</topic><topic>Brain - pathology</topic><topic>Brain Injuries - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Infant</topic><topic>Male</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gleckman, A M</creatorcontrib><creatorcontrib>Bell, M D</creatorcontrib><creatorcontrib>Evans, R J</creatorcontrib><creatorcontrib>Smith, T W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gleckman, A M</au><au>Bell, M D</au><au>Evans, R J</au><au>Smith, T W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining</atitle><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle><addtitle>Arch Pathol Lab Med</addtitle><date>1999-02-01</date><risdate>1999</risdate><volume>123</volume><issue>2</issue><spage>146</spage><epage>151</epage><pages>146-151</pages><issn>0003-9985</issn><abstract>Accurate identification of diffuse axonal injury is important in the forensic investigation of infants who have died from traumatic brain injury. beta-Amyloid precursor protein (beta-APP) immunohistochemical staining is highly sensitive in identifying diffuse axonal injury. However, the effectiveness of this method in brain-injured infants has not been well established. The present study was undertaken to assess the utility of beta-APP immunohistochemistry in detecting diffuse axonal injury in infants with either shaken baby syndrome or blunt head trauma.
Archival formalin-fixed, paraffin-embedded blocks from infants (<1 year old) with shaken baby syndrome (7 cases) and blunt head trauma (3) and blocks from 7 control cases that included nontraumatic cerebral edema (1), acute hypoxic-ischemic encephalopathy (1), and normal brain (5) were immunostained for beta-APP. A semiquantitative assessment of the severity of axonal staining was made. Corresponding hematoxylin-eosin-stained sections were examined for the presence of axonal swellings.
Immunostaining for beta-APP identified diffuse axonal injury in 5 of 7 infants with shaken baby syndrome and 2 of 3 infants with blunt head trauma. Immunoreactive axons were easily identified and were present in the majority of the sections examined. By contrast, hematoxylineosin staining revealed axonal swellings in only 3 of 7 infants with shaken baby syndrome and 1 of 3 infants with blunt head trauma. Most of these sections had few if any visible axonal swellings, which were often overlooked on initial review of the slides. No beta-APP immunoreactivity was observed in any of the 7 control cases.
Immunostaining for beta-APP can easily and reliably identify diffuse axonal injury in infants younger than 1 year and is considerably more sensitive than routine hematoxylin-eosin staining. We recommend its use in the forensic evaluation of infants with fatal craniocerebral trauma.</abstract><cop>United States</cop><pmid>10050789</pmid><tpages>6</tpages></addata></record> |
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| ispartof | Archives of pathology & laboratory medicine (1976), 1999-02, Vol.123 (2), p.146-151 |
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| language | eng |
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| source | MEDLINE; Allen Press Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Amyloid beta-Protein Precursor - analysis Axons Battered Child Syndrome - pathology Brain - pathology Brain Injuries - pathology Child Child, Preschool Female Humans Immunohistochemistry Infant Male |
| title | Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining |
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