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57. Jahrestagung der Deutschen Gesellschaft für Neuropathologie und Neuroanatomie (DGNN)

Deutsche Gesellschaft für Neuropathologie und Neuroanatomie

12. - 15.09.2012, Erlangen

Banner: 57. Jahrestagung der Deutschen Gesellschaft für Neuropathologie und Neuroanatomie

Clinical significance of neuropathological data in severe brain injuries

Meeting Abstract

  • presenting/speaker Dieter Woischneck - Klinikum Landshut, Neurosurgery, Landshut, Germany
  • Thomas Kapapa - Universitätsklinikum, Neurosurgery, Ulm, Germany
  • Norbert Blumstein - Klinikum Landshut, Nuclear medicine, Landshut, Germany
  • Christoph Grimm - Universitätsklinikum, Neurosurgery, Ulm, Germany
  • Dietmar Thal - Universitätsklinikum, Neurosurgery, Ulm, Germany; Universitätsklinikum Ulm, Neuropathology, Ulm, Germany

Deutsche Gesellschaft für Neuropathologie und Neuroanatomie. 57th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN). Erlangen, 12.-15.09.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgnnPP7.4

DOI: 10.3205/12dgnn130, URN: urn:nbn:de:0183-12dgnn1300

Veröffentlicht: 11. September 2012

© 2012 Woischneck et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Question: During operation of traumatic intracranial pathologies, spicemen for histological examinations are easily attained. Nevertheless, in contrast to other neurosurgical procedures, their predictive power has never been analyzed for clinical routine.

Methods: With permission of the local ethics comittee, sampies of brain tissue from 25 survivors after sever brain injury (BI) were collected within one week after the accident and histologically analyzed. Sampies consist of brain tissue within extracranial brain prolaps (n=2), the contence of ventricular catheters (n=7) and the peripheral parts of intracranial bleedings and contusions (n=16). The results were classified and statistically described. Magnetic resonance imaging (MRI) data and Glasgow Outcome Score (GOS) 6 months postinjury were correlated.

Results: The most frequent entities were diapedic bledding (80%), diffuse axonal injury (DAI) (50%) and intraneuronal calcification (20%). When samples were taken within 4 - 10 hours after the accident, diapedic bleedings could be detected. DAI was visualized in spicemen gained up from 10 hours after injury, calcifications in samples taken up from the third day. The cerebral locations of DAI suspected lesions in MRI and of probes were not in concordance. In patients without histological verification for DAI, MRI gave a positive result in 50%. GOS did not correlate significantly with any of these findings (cross table, Chi2-test).

Concluslons: Diapedic bleedings seem to be to frequent and intraneuronal calcifications to rare to be of significant predictive power in severe brain injuries. The finding of diffuse axonal injury may enhance predictive potency, but it is unclear, in which patients. Time course and MRI findings seem to be essential, additive informations. The study design should be affiliated by other centres to increase the number of patients recruited, and to clarify the correlations of histopathological data with MRI and outcome.