Study on differential diagnosis of traumatic or intrinsic cerebral hematoma of the basal nucleus by use of immunohistochemical markers of blood vessels

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1. Immunohistochemical studies on axonal changes concerning differential diagnosis of intrinsic or traumatic cerebral hematoma : Immunostaining for amyloid precursor protein (APP), neuron-specific enolase (NSE) and neurofilament (NF) 160 labeled varicose axons and axonal bulb in traumatic cases of more than 2 hours-survival. Immunostaining for mitochondria leveled axonal bulb in traumatic cases of more than 1 day-survival. Immunostaining for NF 200 leveled axons regardless of traumatic or non-traumatic cases.2. Immunohistochemical studies on markers of the blood vessels : Immunostaining for angiotensin converting enzyme (ACE) leveled unstable plaques of arteriosclerosis in cases of intrinsic cerebral hematoma. However, ACE labeled plaques in one case of intrinsic hematoma.3. Application to actual autopsy cases : In a case of death 3 weeks after suffering from a traffic accident, an autopsy revealed left extensive cerebral hematoma, cerebral contusion and subarach- noidal hemorrhage. Immunostaining for APP and NSE leveled axonal bulbs. Immunostaining for ACE failed to label vessels. From these findings, we diagnosed that the hematoma is due to trauma. In a case of death after suffering from a lot of skin injuries, an autopsy revealed left extensive cerebral hematoma. Immunostaining for ACE labeled many vessels. From these findings, we judged that the hematoma is due to trauma. In this case, immunostaining for NSE leveled axonal bulbs, suggesting that it should be important to examine several immunostainings before diagnosing.