Axonal Injury in Young Pediatric Head Trauma: A Comparison Study of B-amyloid Precursor Protein (B-App) Immunohistochemical Staining in Traumatic and Nontraumatic Deaths

• NCJ Number: 236191
• Journal: Journal of Forensic Sciences Volume: 56 Issue: 5 Dated: September 2011 Pages: 1198-1205
• Author(s): Michael W. Johnson, M.D., Ph.D.; Lisa Stoll, M.D., M.P.H.; Ana Rubio, M.D., Ph.D.; Juan Troncoso, M.D.; Olga Pletnikova, M.D.; David R. Fowler, M.D.; Ling Li, M.D.
• Date Published: September 2011
• Length: 8 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America
• Note: Presented at the 62nd Annual Meeting of the American Academy of Forensic Sciences, February 22–27, 2010, in Seattle, WA.

Annotation

This study tested the independent utility of beta-amyloid forerunner protein (beta-APP) immunohistochemical staining as evidence of brain trauma in the deaths of young children.

Abstract

Blinded reviewers retrospectively reviewed immunostained brain tissues from homicidal deaths, age-matched control cases without evidence of trauma, as well as cases of sudden infant death syndrome (SIDS). The reviewers correctly identified five of the seven cases with documented inflicted head trauma. However, one of seven age-matched control cases and one of 10 SIDS/sudden unexplained death in infancy (SUDI) cases demonstrated staining patterns similar to those seen in cases of inflicted trauma. The study discusses these cases and the circumstances surrounding them with the intent to explain the difficulties associated with immunohistological interpretation of axonal injury. Although the utility of beta-APP is quite powerful if not confounded by global hypoxic-ischemic injury, ultimately, beta-APP studies should be only one piece of information in the determination of cause and manner of death. (Published Abstract)