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

确定小岛屿发展中国家的死亡原因是法医学和儿科学领域最重要的任务之一。对20例小儿麻痹症患者和13例其他死因死亡患者(对照组)的大脑进行了三维图像分析，测量了(A)后颅腔容量和(B)其下部容量，(A)小脑、桥脑和延髓整体体积，(B)延髓体积。结果发现，随着婴儿年龄的增长，所有的容量和体积都会增加。在同月龄组(2~11个月龄)之间比较，除B组外，其他各年龄组的值均小于正常对照组。相反，小岛屿发展中国家的B值更大。这些结果表明，不仅颅骨和大脑发育不成熟，而且颅骨的结构问题也很容易被小脑扁桃体内陷。接下来，通过二维图像分析，测量小脑皮质外颗粒层厚度、小颗粒细胞数和血管周围空洞数，并在同月龄组之间进行比较。因此，(1)和(2)在SID病例中显示脑不成熟，(3)显示上述颅内压升高(脑水肿)的证据。

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).