Interpretation of neuropathological lesions: its limitations in medico-legal experts' reports.
Aggressive or paradoxical behaviour may reflect an organic dementia. The most frequent is Alzheimer's disease, which results from an abnormal structural conformation of tubulin-associated protein (tau) and beta-amyloid protein that, respectively, aggregate in certain neurons as intracellular neurofibrillary tangles (NFTs) and in the extracellular environment as senile plaques. These lesions progress in the brain tissue according to the stages described by Braak and Braak. Staging of neurofibrillary pathology has proven anatomical and clinical correlation, which can be used in a medico-legal procedure. We report two cases demonstrating discrepancies between anatomical and clinical features, which should encourage medical expert to prudence when interpreting neuropathological reports.
Piercecchi-Marti
Marie-Dominique
MD
Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, Marseille, France. marie-dominique.piercecchi@mail.ap-hm.fr
De Paula
Andre Maues
AM
Gavaudan
Gilles
G
Bartoli
Christophe
C
Pelissier-Alicot
Anne-Laure
AL
Leonetti
Georges
G
Pellissier
Jean-François
JF
D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D016229:Amyloid beta-Peptides / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis; D001921:Brain / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000473:pathology; D004282:Documentation; D005260:Female; D049429:Forensic Pathology / Q000331:legislation & jurisprudence*; D006801:Humans; D007150:Immunohistochemistry; D016874:Neurofibrillary Tangles / Q000473:pathology; D009474:Neurons / Q000473:pathology; D009483:Neuropsychological Tests; D009929:Organ Size; D058225:Plaque, Amyloid / Q000473:pathology
D016229:Amyloid beta-Peptides; D001323:Autoantibodies