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

1.脑内血肿与外伤性血肿鉴别诊断中轴突改变的免疫组织化学研究：存活超过2小时的外伤性血肿患者的轴突和轴索球中淀粉样前体蛋白(APP)、神经元特异性烯醇化酶(NSE)和神经丝蛋白(NF)160标记的免疫组织化学染色。存活超过1天的创伤性病例中，线粒体免疫染色使轴突变平。结论：1.无论创伤性或非创伤性病例，NF200免疫组织化学染色均使轴突变平。血管标记物的免疫组织化学研究：血管紧张素转换酶(ACE)免疫组织化学染色使脑内血肿患者动脉硬化的不稳定斑块变平。然而，在1例内源性血肿中，血管紧张素转换酶标记斑块。应用于实际尸检病例：1例车祸后3周死亡，尸检发现左侧广泛脑血肿、脑挫伤和蛛网膜下腔出血。APP和NSE免疫染色使轴突变平。血管紧张素转换酶免疫组织化学染色未能标记血管。根据这些发现，我们诊断血肿是由于创伤造成的。在一起死于多处皮肤损伤的案例中，尸检发现留下了广泛的脑血肿。血管紧张素转换酶免疫组织化学标记多条血管。根据这些发现，我们判断血肿是由于创伤造成的。在这种情况下，NSE的免疫染色使轴突变平，这表明在诊断之前检查几种免疫染色是很重要的。

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.