Untargeted and targeted metabolomics analysis of CO poisoning and mechanical asphyxia postmortem interval biomarkers in rat and human plasma by GCMS.

Accurate and objective estimation of the postmortem interval (PMI) is crucial in forensic practice. This study aimed to infer PMI through equations based on the relationship between PMI and metabolomics biomarkers.Rats were subjected to models representing various temperatures and causes of death, with blood collected at different intervals. Untargeted gas chromatographymass spectrometry metabolomics detection methods were developed, and candidate biomarkers were chosen as co-differentially expressed metabolites in four models. A targeted method was then developed for quantitatively determining candidate biomarkers. Animal tests and human cadaver samples with clearly documented causes of death and time were used to verify the reliability of the regression equation.Results: Unique differential metabolites for CO poisoning deaths included 2,3-butanediol, hypoxanthine, and dehydrated hexanol, while those for mechanical asphyxia deaths comprised propylamine, 1,3-propylene glycol, phosphoric acid, and sorbitol. Pyruvate, glycerol and isoleucine were identified as candidate biomarkers. Human case results demonstrated the method's potential (error rate < 20 %). The findings of this study may offer reference points for estimating PMI and causes of death in forensic practice.

[Inspection of deceased : Issuing a death certificate]. / Prähospitale Leichenschau : Durchführung und das Ausstellen der Todesbescheinigung.

The obligatory post-mortem examination and the issuing of a death certificate are among the more unpopular medical tasks. Nevertheless, the legislature has entrusted the medical profession with a socially important task that should be carried out carefully. The examining physician decides whether the death remains a private matter or whether an official death investigation should first shed light on the circumstances of the death. The post-mortem examination system is the only instrument for the systematic detection of homicide offences. The prerequisite for issuing a death certificate is a carefully conducted external post-mortem examination, which must be carried out in full at least when certifying a natural or unexplained cause of death. In addition, the medical information on the death certificate serves epidemiological and health policy purposes and contains important information on infection control.

A Case of Hanging with Limited Specific Postmortem Brain Imaging.

In Japan, the number of autopsies has steadily decreased. Therefore, postmortem imaging methods have positioned as valuable supplemental or complementary tools in autopsy procedures. We clinicians are increasingly faced with the need to infer cause of death from postmortem imaging findings. We report computed tomography (CT) and magnetic resonance imaging (MRI) findings of a 41-year-old man who committed suicide by hanging. CT revealed fractures of the left superior horn of the thyroid cartilage. Head MRI showed high signal intensity in the basal ganglia on the T1-weighted image and high-intensity rims along the cerebral cortex on the diffusion-weighted image; however, these were considered normal postmortem changes. There were no significant findings in the heart, major blood vessels, or abdominal organs. The contents of the stomach were minimal, and no tablets or other evidence suggestive of drug overdose were identified. Traumatic changes were not observed. Based on the scene and his circumstances, it was speculated that he died by hanging and an autopsy was not performed. This case highlights the importance of understanding normal postmortem brain imaging changes to estimate the true cause of death.

A systematic review on the use of C-reactive protein in autopsy practice.

Postmortem analysis of C-reactive protein (CRP) in autopsies has been extensively researched for its potential utility. This analysis could aid forensic pathologists in screening for and investigating the potential infectious or inflammatory causes of death, thereby guiding appropriate autopsy procedures. To assess the diagnostic accuracy of postmortem CRP analysis in autopsy settings, a thorough electronic literature search was conducted across databases such as PubMed, Scopus, Web of Science, and Cochrane Library. Two independent reviewers screened eligible studies, followed by a methodological quality assessment using the QUADAS-2 checklist. Utilising a random-effects model, hierarchical summary receiver operating characteristic (HSROC) curve analysis and bivariate model meta-analysis were performed to evaluate heterogeneity across studies. Of the 1286 studies initially identified, nine met the eligibility criteria for the final analysis. The pooled sensitivity of postmortem CRP analysis was 0.93 (95% CI, 0.76, 0.98), with a pooled specificity of 0.80 (95% CI, 0.71, 0.87). The prevalence across studies ranged from 0.23 to 0.68, with a median of 0.5. Moderate variability was observed in the heterogeneity assessment across the primary studies. In summary, the study findings indicate that postmortem serum CRP analysis demonstrates high diagnostic accuracy with moderate heterogeneity. Additionally, postmortem CRP testing may be useful as a screening tool in autopsy practice to rule out the likelihood of sepsis.

Automated deep learning segmentation of high-resolution 7 Tesla postmortem MRI for quantitative analysis of structure-pathology correlations in neurodegenerative diseases.

Postmortem MRI allows brain anatomy to be examined at high resolution and to link pathology measures with morphometric measurements. However, automated segmentation methods for brain mapping in postmortem MRI are not well developed, primarily due to limited availability of labeled datasets, and heterogeneity in scanner hardware and acquisition protocols. In this work, we present a high-resolution dataset of 135 postmortem human brain tissue specimens imaged at 0.3 mm3 isotropic using a T2w sequence on a 7T whole-body MRI scanner. We developed a deep learning pipeline to segment the cortical mantle by benchmarking the performance of nine deep neural architectures, followed by post-hoc topological correction. We evaluate the reliability of this pipeline via overlap metrics with manual segmentation in 6 specimens, and intra-class correlation between cortical thickness measures extracted from the automatic segmentation and expert-generated reference measures in 36 specimens. We also segment four subcortical structures (caudate, putamen, globus pallidus, and thalamus), white matter hyperintensities, and the normal appearing white matter, providing a limited evaluation of accuracy. We show generalizing capabilities across whole-brain hemispheres in different specimens, and also on unseen images acquired at 0.28 mm3 and 0.16 mm3 isotropic T2*w fast low angle shot (FLASH) sequence at 7T. We report associations between localized cortical thickness and volumetric measurements across key regions, and semi-quantitative neuropathological ratings in a subset of 82 individuals with Alzheimer's disease (AD) continuum diagnoses. Our code, Jupyter notebooks, and the containerized executables are publicly available at the project webpage (https://pulkit-khandelwal.github.io/exvivo-brain-upenn/).

Development and age estimation of the intrapuparial period of Phormia regina (Diptera: Calliphoridae) for postmortem interval estimation.

Phormia regina (Meigen, 1826; Diptera: Calliphoridae) is a Holarctic species that rapidly colonizes carcasses and has been used as an indicator for determining the minimum postmortem interval. However, studies using morphological methods to estimate the intrapuparial age of P. regina are lacking. In this study, morphological changes within the puparium were observed under a stereomicroscope at 7 constant temperatures ranging from 16 °C to 34 °C. The intrapuparial period was categorized into 12 substages. Morphological indicators, including compound eyes, mouthparts, antennae, thorax, legs, wings, and abdomen, were recorded in detail. The observed morphological changes were divided into 6-10 substages, and the duration of each substage was also recorded in detail. The results of this study provide primary data for using the intrapuparial morphology of P. regina when pupae are collected at a crime scene and estimating the minimum postmortem interval.

Forensic significance of postmortem pink teeth: A narrative review.

OBJECTIVE: To review the phenomenon of postmortem pink teeth, exploring its etiology, correlation with the cause of death, and the potential forensic significance of this medico-legal finding. METHODS: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and B-on, employing keywords like "Forensic Pathology," "Forensic Dentistry," "Pink Teeth," and "Medico-legal aspects." The search included studies without temporal limits to gather extensive data on the postmortem pink teeth phenomenon. RESULTS: The postmortem pink teeth phenomenon is characterized by a red-pink discoloration of the dentin, typically sparing the enamel. It is most often observed in moist environments and cases involving water immersion, strangulation, and carbon monoxide poisoning. The study found no consistent relationship between the pink discoloration and specific causes of death, suggesting the phenomenon is more closely related to environmental conditions and the state of decomposition. The pink coloration is more prevalent in anterior, single-rooted teeth and younger individuals. CONCLUSION: The postmortem pink teeth phenomenon remains a complex and enigmatic finding in forensic science. While it does not conclusively indicate a specific cause of death, understanding its occurrence can aid forensic investigations. Further research is needed to elucidate this phenomenon's mechanisms and validate its forensic relevance.

[Forensic imaging of sharp force injuries]. / Forensische Bildgebung der scharfen Gewalt.

BACKGROUND: Answering legal questions is everyday routine in forensic medicine. The reconstruction of violent crimes following attacks with sharp and/or pointed instruments is usually complex and can hardly be adequately answered using traditional forensic methods such as autopsies. For this reason, clinical and postmortem radiology has become the ideal complement to forensic medicine. METHODS: While classic X­ray is unsuitable to image soft tissue injuries, and magnetic resonance imaging is too expensive, too complex and also not available everywhere, multislice computed tomography (MSCT) has now emerged as the method of choice in forensic imaging for the assessment of the consequences of sharp force injuries. ACHIEVEMENTS: Forensic imaging, especially MSCT, offers an indispensable addition to reconstruction, particularly after stab wounds. In many cases, it is at least equal to, and in some cases superior to, the classic autopsy in the assessment of stab wounds, the reconstruction of the sequence of events or the assessment of (life-threatening) injuries. CONCLUSIONS: The forensic radiological assessment after sharp violence requires experience in both the field of radiology and forensic medicine. Provided that both disciplines work closely together, forensic radiology can be an essential tool in the care for victims of violence.

[Blunt force trauma in forensic radiology]. / Stumpfe Gewalt in der forensischen Radiologie.

OBJECTIVE: Description of the main forensic radiological examination modalities and findings in blunt force trauma in living and deceased adults. METHODS: Elaboration of the essential points based on the authors' own experiences and relevant literature. RESULTS AND CONCLUSION: Injury-related consequences of blunt force are frequently observed in forensic radiological diagnostics, especially in the context of accidents and suicides, and less frequently in homicides. The method of choice for radiological imaging of blunt force in deceased persons is native postmortem computed tomography (PMCT). In principle, the radiological effects of blunt force in PMCT do not differ significantly from those in living persons. Postmortem magnetic resonance imaging (PMMRI) is very suitable for imaging blunt soft tissue injuries in the shorter postmortem interval. In the case of living individuals with the consequences of blunt force trauma, imaging is primarily indicated for clinical diagnostic reasons. Common indications are domestic violence, violence against the elderly, and disputes in public spaces. The choice of radiological examination method depends on the clinical history and symptoms, and the radiological examinations can be subjected to a forensic assessment.

The Rise of Bromazolam in Postmortem Cases from Travis County, Texas and Surrounding Areas: 2021-2023.

As novel psychoactive substances (NPS) have continued to emerge over the last decade, NPS benzodiazepines have likewise increased in prevalence. They pose an evolving threat to public health and safety with regard to postmortem cases, particularly when used in combination with opioids. Bromazolam was first detected in Travis County, Texas (TX) in April 2021. Given the recent onset of the fentanyl epidemic in this region, the international rise of bromazolam, and increased reports of "benzo-dope", a retrospective study was conducted to characterize bromazolam-positive deaths in Travis County and surrounding counties from 2021-2023. Bromazolam was identified in 112 deaths from 2021-2023, accounting for 1.57% of cases submitted for toxicology testing (n=7,129). During that interval, a 7.5-fold increase was observed in postmortem bromazolam-related drug toxicities from 2021 (n=7) to 2023 (n=53). Fatalities primarily occurred in males in their early-30's. Postmortem concentrations ranged from 21-220 ng/mL, with mean (median) concentrations of 69.4 ± 48.4 (53.5) ng/mL. Polydrug use was present in 99% of bromazolam-positive deaths with co-occurrence with other drugs and drug classes widely varying over time. Bromazolam was attributed as the sole cause of death in one case with a postmortem blood concentration of 23 ng/mL. Polydrug use in bromazolam-related drug toxicities commonly involved fentanyl (82%), methamphetamine (41%), and cocaine (28%). Similarly, cases where bromazolam was an incidental finding and non-contributory to the cause of death often involved methamphetamine (38%), alprazolam (33%), and cocaine (33%). In light of the significant increase in fentanyl-related deaths in Travis County, the increasing prevalence of bromazolam accompanying fentanyl was particularly alarming due to the heightened risk of toxicity when used in combination. Identifying and evaluating bromazolam-related deaths clarifies the impact of bromazolam on this population, promotes awareness, and aids in identifying meaningful harm reduction strategies to decrease bromazolam-related morbidity and mortality.

An assessment of the Henssge method for forensic death time estimation in the early post-mortem interval.

BACKGROUND: Time-since-death (TSD) diagnostics are crucial in forensic medical casework. The compound method by Henssge and Madea, which combines temperature and non-temperature-based techniques, is widely used to estimate TSD. This study aims to validate the predictive ability of this method in a cohort of 76 deceased individuals with known times of death (TOD). METHODS: A convenience sample of 76 deceased individuals was examined at the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf. The study included individuals who died at the hospital and those with sudden death in public. Exclusion criteria included age under 18, known infection or sepsis, polytrauma, bleeding, and hyperthermia. The TSD interval was calculated using the Deathtime software. RESULTS: The overall agreement between the actual TOD and the 95% prediction interval for the TSD was 36.8% (95% CI: 26.1 to 48.7). Warm-stored corpses showed a higher agreement (61.9% [95% CI: 38.4 to 81.9]) compared to cold-stored corpses (27.3% [95% CI: 16.1 to 41.0]). Factors such as body mass index (BMI) and body surface area (BSA) were found to influence the odds of agreement. Assuming a plausible range of ambient temperatures between death and admission improved the agreement in cold-stored cases. CONCLUSION: The study found low to moderate agreement between the actual TOD and the 95% prediction interval using the Henssge method. Incorporating BMI and BSA could improve the predictive accuracy of TSD estimations. Further research with larger sample sizes and external validation is recommended to refine the model.

Exploring factors associated with increased suicides during the COVID-19 pandemic in Japan: A study using data from postmortem examinations conducted in an urban area.

Aim: The purpose of this study is to examine factors associated with increased suicide deaths during the coronavirus disease 2019 (COVID-19) pandemic in Japan using primary data from postmortem examinations. Methods: We explored factors associated with suicides that occurred during the COVID-19 pandemic (February 2020 to December 2021) using data from 115 postmortem examinations of suicides that occurred in one city in the Kanto region between January 2017 and December 2021. Results: Multivariate analysis using graphical modelling and logistic regression analysis showed that both female sex (adjusted odds ratio: 3.732; 95% confidence interval: 1.044-13.345) and multiple mental disorders (adjusted odds ratio: 7.344; 95% confidence interval: 1.316-40.987) were significantly associated with suicide during the COVID-19 pandemic among the young age group (39 years or under). Conclusion: The study results suggest that in addition to the factor of female sex previously identified, morbidity due to multiple mental disorders may be associated with the increased suicides in Japan during the COVID-19 pandemic. Furthermore, this study presented the new methodological possibility of analyzing background factors of suicide using postmortem examination data. In preparation for similar emergencies in the future, it is necessary to establish a system that provides care for multiple mental disorders and a continuous suicide-monitoring system that combines methods such as psychological autopsies with other methods.

Comparative analysis of in situ and ex situ postmortem brain MRI: Evaluating volumetry, DTI, and relaxometry.

PURPOSE: To compare postmortem in situ with ex situ MRI parameters, including volumetry, diffusion tensor imaging (DTI), and relaxometry for assessing methodology-induced alterations, which is a crucial prerequisite when performing MRI biomarker validation. METHODS: MRI whole-brain scans of five deceased patients with amyotrophic lateral sclerosis were performed at 3 T. In situ scans were conducted within 32 h after death (SD 18 h), and ex situ scans after brain extraction and 3 months of formalin fixation. The imaging protocol included MP2RAGE, DTI, and multi-contrast spin-echo and multi-echo gradient-echo sequences. Volumetry, fractional anisotropy, mean diffusivity, T1, T2, and T 2 * $$ {T}_2^{\ast } $$ have been assessed for specific brain regions. RESULTS: When comparing ex situ to in situ values, the following results were obtained. Deep gray matter as well as the thalamus and the hippocampus showed a reduced volume. Fractional anisotropy was reduced in the cortex and the whole brain. Mean diffusivity was decreased in white matter and deep gray matter. T1 and T2 were reduced in all investigated structures, whereas T 2 * $$ {T}_2^{\ast } $$ was increased in the cortex. CONCLUSION: The results of this study show that the volumes and MRI parameters of several brain regions are potentially affected by tissue extraction and subsequent formalin fixation, suggesting that methodological alterations are present in ex situ MRI. To avoid overlap of indistinguishable methodological and disease-related changes, we recommend performing in situ postmortem MRI as an additional intermediate step for in vivo MRI biomarker validation.

Multi-Class Analysis of 57 Drugs Quantitatively in Blood and Qualitatively in Urine by LC-MS/MS to Complement Comprehensive DFC, DUID and Postmortem Testing.

A streamlined LC-MS/MS method utilizing protein precipitation and filtration extraction was developed to consolidate analyses for drug-facilitated crime (DFC), postmortem investigations, and driving under the influence of drugs (DUID) testing. Fifty-seven target drug and metabolite analytes eluted in under 6-minutes and compromised of GHB precursors (1), hallucinogens (3), muscle relaxants (3), anticonvulsants (7), antidepressants (20), antihistamines (5), antipsychotics (11), antihypertensives and alpha-adrenergics (3), analgesics and anesthetics (3), and miscellaneous (1) in blood (quantitatively) and urine (qualitatively). Limits of detection were set to meet the more challenging sensitivity requirements for DFC, and are therefore also suitable for postmortem investigations, and other forensic casework, including DUID. Comprehensive ASB/ANSI validation was performed, and applicability studies examined 72 proficiency test blood and urine samples, along with 9,206 unique blood and urines samples from 5,192 authentic forensic cases that resulted in 11,961 positive analytes in samples. By expanding the analytical reach across multiple drug classes through a unified approach and screening a wider number of drugs, the technique can identify substances that might have previously evaded detection, thereby enhancing laboratory efficiency by minimizing the need for multiple tests. When combined with a recently developed in-house method, this integrated testing strategy meets the testing requirements outlined in ASB/ANSI standards and recommendations for DFC, postmortem, and Tier 1 DUID analyses.

Identification of 5-aminometonitazene and 5-acetamidometonitazene in a post-mortem case: Are nitro-nitazenes unstable?

In recent years the use of 2-benzylbenzimidazole opioids ('nitazenes') has increased with them becoming one of the most prominent synthetic opioid subclasses of novel psychoactive substances. With the increased prevalence there is also a concern of the dangers to public health with the use of nitazenes due to their high potency especially with polypharmacy. To aid in the detection of such compounds it is important that forensic toxicology laboratories maintain up-to-date compound libraries for drug screening methods and that sensitive analytical instrumentation is available to detect the low blood/plasma concentrations of more potent drugs. This includes not only the compounds themselves but also potential metabolites and/or degradation products. Metonitazene is a 'nitro-nitazene' with a nitro group at position 5 of the benzimidazole ring. As a nitro-nitazene there is a potential for bacterial degradation of metonitazene to 5-aminometonitazene, as occurs with nitro-benzodiazepines. In this study we provide evidence from a post-mortem case of degradation of metonitazene in unpreserved post-mortem blood using LC-QQQ-MS, and putative identification of the degradation/ metabolic products 5-aminometonitazene and 5-acetamidometonitazene by LC-QTOF-MS. The results from LC-QQQ-MS analysis indicated that there did not appear to be such degradation in preserved (fluoride/oxalate) blood. These results suggest that nitro-nitazenes may be subject to similar in vitro stability/degradation issues as nitro-benzodiazepines. These breakdown products should be added to instrument libraries to aid in the detection of the use of nitro-nitazenes, and nitro-nitazenes should be quantified in preserved blood samples where available.

A postmortem high-resolution MRI study of the development of cochlear nerve-related structures in the second and third trimesters of pregnancy.

Background: Magnetic resonance imaging (MRI) is used to determine whether cochlear nerve development is normal in infants and adults, but it has not yet been used to evaluate cochlear nerve development or measure cochlear nerve-related structures in the fetus. This study sought to provide imaging data for clinical evaluations concerning cochlear nerve development in the fetus using MRI. Methods: Postmortem 3.0-Tesla MRI of inner ear was performed in 51 fetuses with normal temporal bones at 25 to 40 weeks of gestation. The continuous scanning protocol incorporated axial three-dimensional (3D) sampling perfection with application-specific contrasts using different flip angle evolution sequences. The images were evaluated to measure the structures of the cochlear aperture (CA), internal auditory canal (IAC), and vestibulocochlear and facial nerves in the cerebellopontine angle (CPA), which have been reported to be associated with cochlear nerve development. We also calculated the ratio between the diameters of the vestibulocochlear and facial nerves. The measurable parameters were compared between the right and left sides. The threshold for statistical significance was set at P<0.05. Results: The inner ear anatomy was discernible on MRI in all the fetal specimens, and growth of the CA, IAC, vestibulocochlear nerve, and facial nerve in the CPA was observed as fetal age increased. There was no significant difference in the measurements of these structures between the right and left sides (all P>0.05). Conclusions: MRI can be used to help evaluate the anatomy and development of the cochlear nerve in the fetus. These normative measurements could be valuable for clinical evaluations of the cochlear nerve.

Usefulness of fat attenuation index in postmortem CT for identifying responsible vessels in acute coronary syndromes: A case report.

Postmortem imaging, particularly unenhanced postmortem computed tomography (PMCT), has been increasingly utilized for pathological or judicial examination as a substitute for conventional autopsy, to compensate very low autopsy rates. While unenhanced PMCT has a limitation in diagnosing acute coronary syndromes, the fat attenuation index (FAI) which is a novel imaging biomarker measured by clinical coronary CT angiography (CCTA), has been known to noninvasively detect coronary artery inflammation. We investigated the postmortem diagnostic usefulness of perivascular FAI measured by CCTA in a 61-year-old male who died suddenly after chest pain. PMCT and autopsy were conducted 92 hours after death. FAI measurement results were -57 Hounsfield units (HU) in the right coronary artery (RCA), -73 HU in the left anterior descending artery (LAD), and -64 HU in the left circumflex artery (LCX). Autopsy revealed significant stenosis in the RCA and LCX, but no significant stenosis was found in the LAD. The elevated FAI in the RCA suggested acute inflammation, which agreed with the autopsy findings. This case is the first to demonstrate effectiveness of FAI measured with PMCT for identifying the vessels responsible for acute coronary syndromes, indicating its potential in postmortem diagnosis.

Superimposed Imaging of Knife and Stab Wound Relationships Through Pre-autopsy and Intra-autopsy Computed Tomography Integration: A Case Report.

Three-dimensional (3D) reconstruction images using postmortem computed tomography (PMCT) are increasingly used to convey complex information to non-medical professionals, such as police and jurors. This case report demonstrates the effective use of 3D reconstruction images by integrating pre-autopsy, intra-autopsy, and knife CT data to achieve precise visualization of the wound path and associated injuries. The case involved a man in his 40s who was stabbed multiple times and pronounced dead approximately two hours after receiving emergency treatment. Initial PMCT revealed an intraperitoneal hemorrhage; however, no injuries to the abdominal organs or aorta were identified. During the autopsy, a critical abdominal aortic injury was discovered, prompting a further CT scan; however, the aorta remained in situ. By utilizing pre-autopsy, intra-autopsy, and knife CT data, the spatial relationships between the stab wound in the right hypochondriac area, aortic injury, and knife were effectively visualized. This novel approach highlights the potential of intra-autopsy CT for precise forensic visualization, offering a strategy for improvements in the accuracy and clarity of forensic evidence presentation.

Differential regulation of physicochemical properties and myofibrillar protein degradation of yak meat by interactions between reactive oxygen species and reactive nitrogen species during postmortem aging.

BACKGROUND: This study aimed to explore how interactions between reactive oxygen species (ROS) and reactive nitrogen species (RNS) affect oxidative properties, nitrosative properties, and myofibrillar protein degradation during postmortem aging of yak meat. RESULTS: Yak longissimus dorsi was incubated with saline, ROS activator (H2O2)/inhibitor N-Acetyl-L-cysteine (NAC) and RNS activator S-Nitrosoglutathione (GSNO)/inhibitor L-NAME hydrochloride (L-NAME) combined treatments at 4 °C for 12, 24, 72, 120, and 168 h. The results indicated that regardless of whether RNS was activated or inhibited, activated ROS played a dominant role in myofibrillar protein degradation by oxidative modification to increase carbonyl content, disulfide bonds, surface hydrophobicity, and dimerized tyrosine while decreasing sulfhydryl content, thereby degrading nebulin, titin, troponin-t and desmin. Notably, the Warner-Bratzler shear force (WBSF) of the H2O2 + L-NAME group was the smallest, whereas that of the NAC + GSNO group was smaller than that of the NAC + L-NAME group. CONCLUSION: These findings provide new insights into meat tenderization patterns through the interaction between ROS and RNS. © 2024 Society of Chemical Industry.

Post-mortem utility of Neuron Specific Enolase (NSE) and Calcium Binding Protein B (S100B) for differentiating traumatic brain injury from other causes of death.

In forensic pathology, identifying causes of death in traumatic brain injuries (TBIs) devoid of observable signs presents a significant challenge. Post-mortem biochemistry plays a crucial role in forensic medicine, particularly in determining causes of death in TBIs that lack macroscopic or histopathological evidence. This study aimed to evaluate the utility of Neuron Specific Enolase (NSE) and S100 Calcium Binding Protein B (S100B) in post-mortem serum and cerebrospinal fluid (CSF) as markers for TBI. The relationship of these biochemical markers with survival time and post-mortem interval was also studied. The study sample consisted of 63 cases each from the TBI and the Non-TBI (NTBI) group. The NTBI group comprised of deaths due to mechanical asphyxia, myocardial infarction and isolated trunk trauma. While serum S100B and CSF NSE emerged as a promising marker for TBI, CSF S100B failed to differentiate TBI from the other causes of death. The absence of an association between the level of markers and survival time or post-mortem interval in TBIs highlights the limitations of these biomarkers in such contexts. This study underscores the potential of biochemical markers like serum S100B and CSF NSE in identifying TBI deaths, aiding forensic diagnoses where there are evidentiary limitations in traditional methods. Further research exploring additional markers and body fluids could enhance diagnostic precision in forensic neuropathology.