Forensic Neuropathological Studies on Alzheimer - Type Dementia

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Autopsied human brain tissues of whole association cortex were examined immunohistochemically. The brains, autopsied at the Department of Legal Medicine, Kobe University School of Medicine and the Medical Examiners Office of Hyogo Prefecture, included 10 cases of acute death consisting of 5 cases of non-demented, 3 cases of Alzheimer-type dementia (ATD) and 2 cases of demented or non-demented unknown. As for patients of ATD,they were clinically diagnosed at some medical facilities in their life time. At the time of each autopsy, whole brain was weighed and right side hemisphere was fixed in 4% formaldehyde solution instantly, and left side hemisphere was sliced with 5 to 10 mm thickness in coronal sections and after fixation for several days in 4% paraformaldehyde 0.01M buffer solution (pH7.4) , fixed by 15% sucrose 0.01M buffer solution (pH7.4). From each side of hemisphere, hippocampus, amygdaloid nucleus, frontal association cortex (superior frontal gyrus) , temporal association cor … More tex (superior temporal gyrus) , visual association cortex and parietotemporal association cortex (angular gyrus) were obtained as tissue blocks and specimens. Each specimen from right side was stained by classical methods and amyloid staining methods, and specimens from left side were stained immunohistochemically with GFAP,lactotransferrin (LF) and HLA-DR.In some ATD cases, senile plaques (SP) were significantly numerous, and in others, neurofibrillary tangles (NFT) were marked strongly. Concerning with predilectional areas of SP and NFT,their scores were also variable. Furthermore, in some areas, SP were numerous and in other ares, NFT were marked dominantly in a case. So, distributions of appearance of SP or NFT were awfully variable in cases and also in areas. Reactive astrocytes and reactive microglias were detected in ATD cases as well as in controls. However, on the whole, they were more detected in ATD cases than in controls and particularly they were detected numerously in areas with marked SP or NFT.Two cases undiagnosed as ATD marked variable scores of SP,NFT,reactive astrocytes and reactive microglias in each area. These cases were synthetically able to be diagnosed as ATD.However, they had some areas without remarkable changes, it was suggested that for the purpose of diagnosing as ATD in the medicolegal autopsy cases, examinations in whole association cortex were needed. Less