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Histopathologic and Morphometoric Studies of the Brain Stem and Cerebellum in Sudden Infant Death Syndrome

婴儿猝死综合症脑干和小脑的组织病理学和形态学研究

基本信息

批准号：
07670504
负责人：
FURUKAWA Masataka
金额：
$ 1.47万
依托单位：
KITASATO UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

项目摘要

Determining the cause of death by SIDS is one of the most important tasks at issue in forensic medicine and pediatrics. We focused on the in fant's brain, and examined the following on 20 cases of SIDS and 13 cases (reference group) of death from other causes.By a three-dimensional image analysis, (A) the capacity of posterior cranial space and (B) the capacity of its lower part, (a) the volume of the whole of cerebellum, pontes and medulla oblongata and (b) the volume of medulla oblongata were measured. As a result, all the capacities and volumes were found to increase as the infants aged. When these values were compared among same-month age groups (2-11 months old), with the exception of B,the values were smaller with SIDS cases than the reference group. In contrast, the value of B was bigger with the SIDS cases. These results indicate, not only immaturity of the cranium and the brain, but also the cranium's structural problem of vulnerability to invagination of cerebellar tonsil. If this happens, it could trigger the perfusion disorder of cerebrospinal fluid and the rise in intracranial pressure, which in turn might affect functions of the respiratory center.Next, by a two-dimensional image analysis, (1) the thickness of the external granular layr of the cerebellar cortex, (2) the number of small granule cells, and (3) the cavity around blood vessels were measured, and compared among the same-month age groups. As a result, (1) and (2) showed immaturity of the brain among SIDS cases, and (3) showed evidence of the aforementioned rise in intracranial pressure (brain edema).

确定SIDS的死因是法医学和儿科学中最重要的任务之一。以脑为中心，对20例SIDS患者和13例其他原因死亡者（对照组）进行了以下检查：（A）颅后间隙容积，（B）颅后间隙下部容积，（a）小脑、桥脑和延髓整体容积，（B）延髓容积。结果发现，随着婴儿年龄的增长，所有的容量和体积都增加。当在相同月龄组（2-11月龄）中比较这些值时，除B外，SIDS病例的值小于参考组。而B值在SIDS病例中较大。这些结果表明，不仅是颅骨和大脑的不成熟，而且是颅骨的结构问题，容易陷入小脑扁桃体。接着，通过二维图像分析，测量了（1）小脑皮质外颗粒层厚度、（2）小颗粒细胞数量、（3）血管周围空腔，并在同月龄组之间进行比较。结果，（1）和（2）显示SIDS病例中的脑未成熟，（3）显示上述颅内压升高（脑水肿）的证据。