Role of vascularization in determining the time of hypoxic-ischemic encephalopathy in the neonate.
OBJECTIVE
To examine the role of vascularization in determining the time of hypoxic-ischemic encephalopathy (HIEP).


METHODS
Brain sections of 126 neonatal autopsy cases were examined for edema, gliosis, congestion, inflammation and ischemia. Capillary vessels were examined with both reticulum stains and antibody against CD34. Vascular surface density (VSD) and number of vessels per stroma (NVES) were calculated by stereologic methods.


RESULTS
Among 126 cases, 64 were male (50.8%) and 62 female (49.2%). In 25 cases HIEP was observed; 14 had a pregnancy history of hypertension, eclampsia or diabetes mellitus in the mother, with fetal distress or underdeveloped features. Statistically, NVES was strongly related to primary HIEP. However, the HIEP and non-HIEP cases revealed no differences in NVES and VSD means.


CONCLUSIONS
Vascularization, especially NVES, helps in determining whether an HIEP case is pregnancy related or due to end-stage changes of dying, but is not an indicator of HIEP.
Aktaş
Ekin Ozgür
EO
Department of Forensic Medicine, Faculty of Medicine, Ege University, Izmir, Turkey. eoaktas@med.ege.edu.tr
Aktaş
Safiye
S
Ortaç
Ragip
R
Diniz
Gülden
G
D001238:Asphyxia Neonatorum / Q000401:mortality / Q000473:pathology*; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002423:Cause of Death; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000473:pathology*; D005311:Fetal Hypoxia / Q000401:mortality / Q000473:pathology*; D005554:Forensic Medicine / Q000379:methods; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000473:pathology*; D007231:Infant, Newborn; D008297:Male; D008833:Microcirculation / Q000473:pathology