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Traumatic axonal injury: neuropathological features, postmortem diagnostic methods, and strategies

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Abstract

Traumatic brain injury (TBI) has high morbidity and poor prognosis and imposes a serious socioeconomic burden. Traumatic axonal injury (TAI), which is one of the common pathological changes in the primary injury of TBI, is often caused by the external force to the head that causes the white matter bundles to generate shear stress and tension; resulting in tissue damage and leading to the cytoskeletal disorder. At present, the forensic pathological diagnosis of TAI-caused death is still a difficult problem. Most of the TAI biomarkers studied are used for the prediction, evaluation, and prognosis of TAI in the living state. The research subjects are mainly humans in the living state or model animals, which are not suitable for the postmortem diagnosis of TAI. In addition, there is still a lack of recognized indicators for the autopsy pathological diagnosis of TAI. Different diagnostic methods and markers have their limitations, and there is a lack of systematic research and summary of autopsy diagnostic markers of TAI. Therefore, this study mainly summarizes the pathological mechanism, common methods, techniques of postmortem diagnosis, and corresponding biomarkers of TAI, and puts forward the strategies for postmortem diagnosis of TAI for forensic cases with different survival times, which is of great significance to forensic pathological diagnosis.

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Acknowledgements

We thank American Journal Experts for their linguistic assistance during the preparation of this manuscript.

Funding

This study is supported by the Guangzhou Science and Technology Program (Grant 2019030011).

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  1. Qianling Chen and Xuebing Chen contributed equally to this work.

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  1. School of Forensic Medicine, Southern Medical University, South Shaitai Road #1023, Guangzhou, 510515, Guangdong, China

    Qianling Chen, Xuebing Chen, Luyao Xu, Rui Zhang, Xia Yue & Dongfang Qiao

  2. Guangzhou Forensic Science Institute & Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou, 510442, China

    Zhigang Li

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  1. Qianling Chen
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Correspondence to Zhigang Li, Xia Yue or Dongfang Qiao.

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Chen, Q., Chen, X., Xu, L. et al. Traumatic axonal injury: neuropathological features, postmortem diagnostic methods, and strategies. Forensic Sci Med Pathol 18, 530–544 (2022). https://doi.org/10.1007/s12024-022-00522-0

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