A case of diffuse axonal injury in violent death

Kaori Mochizuki, Hiroshi Ochi, Yoshiaki Ogura, Morio Iino, Hisanaga Kuroki, Ryoji Matoba

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 59-year-old man was carried to the hospital by three men. The deceased was unconscious at admission and his face was severely swollen with many subcutaneous hemorrhages and extensive edema. His death was confirmed 17 min after resuscitation. A judicial autopsy was performed the next day. Findings showed that the victim's face and head were reddish and swollen, and that subscalp bleeding was ubiquitous, but no skull fracture, epi- and subdural hematoma or subarachnoidal bleeding was observed. The brain itself was severely edematous but no bleeding was found. Although small hemorrhages were seen in the limbs and back, there were no marked wounds except to the head. To determine the cause of death, we performed a microscopic histochemical examination. Conventional H.E. staining disclosed eosinophilic change, concentration of nuclei, edema, gliosis, and oozing at the corpus callosum. To identify further details of the cause of death, we used Bodian staining, Kluver-Barrera staining, anti-beta amyloid immunostaining, and anti-neurofilament immunostaining. We found sinusoidal swelling of axons and waving axons, which are typical findings of Diffuse Axonal Injury (DAI), but no positive staining of beta amyloid. Focal lesions of the corpus callosum and of the dorsolateral quadrant of the rostral brain stem, and diffuse damage to axons are considered to constitute the DAI triad. We therefore diagnosed the cause of death as DAI. Our experience shows that it is important to use several staining methods for diagnosis of a variety of neuronal degenerative disorders. Several days later, we were informed by the police that several men had hit and kicked the victim in an attempt to lynch him. To compare with this case, we also report two other cases in which DAI was observed.

Original languageEnglish
JournalLegal Medicine
Volume11
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 01-04-2009

Fingerprint

Diffuse Axonal Injury
Staining and Labeling
Hemorrhage
Axons
Cause of Death
Corpus Callosum
Amyloid
Edema
Head
Skull Fractures
Subdural Hematoma
Gliosis
Intermediate Filaments
Police
Resuscitation
Brain Stem
Autopsy
Extremities
Wounds and Injuries
Brain

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Issues, ethics and legal aspects

Cite this

Mochizuki, K., Ochi, H., Ogura, Y., Iino, M., Kuroki, H., & Matoba, R. (2009). A case of diffuse axonal injury in violent death. Legal Medicine, 11(SUPPL. 1). https://doi.org/10.1016/j.legalmed.2009.02.039
Mochizuki, Kaori ; Ochi, Hiroshi ; Ogura, Yoshiaki ; Iino, Morio ; Kuroki, Hisanaga ; Matoba, Ryoji. / A case of diffuse axonal injury in violent death. In: Legal Medicine. 2009 ; Vol. 11, No. SUPPL. 1.
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Mochizuki, K, Ochi, H, Ogura, Y, Iino, M, Kuroki, H & Matoba, R 2009, 'A case of diffuse axonal injury in violent death', Legal Medicine, vol. 11, no. SUPPL. 1. https://doi.org/10.1016/j.legalmed.2009.02.039

A case of diffuse axonal injury in violent death. / Mochizuki, Kaori; Ochi, Hiroshi; Ogura, Yoshiaki; Iino, Morio; Kuroki, Hisanaga; Matoba, Ryoji.

In: Legal Medicine, Vol. 11, No. SUPPL. 1, 01.04.2009.

Research output: Contribution to journalArticle

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Mochizuki K, Ochi H, Ogura Y, Iino M, Kuroki H, Matoba R. A case of diffuse axonal injury in violent death. Legal Medicine. 2009 Apr 1;11(SUPPL. 1). https://doi.org/10.1016/j.legalmed.2009.02.039