ACCUMULATION OF PLASMA PROTEINS IN NEURONS, PURKINJE CELLS, AND BERGMANN GLIA AS A MARKER OF FUNCTIONAL DISRUPTION OF BLOOD-BRAIN BARRIER IN THE EARLY PHASE OF TRAUMATIC BRAIN INJURY IN THE POST MORTEM EXAMINATION

The diagnosis of traumatic brain injury (TBI) is routinely observed in forensic practices, such as autopsies and neuropathological screenings. Observable pathophysiological features of TBI consist of variable micro- and macrostructural neuropathologies visible in a light microscope. Various currently introduced approaches permit in vivo imaging and the use of many exogenous markers, which now show emerging capabilities that are of particular interest to forensic and neuropathological diagnostics. The important role of BBB disruption and malfunction, as well as its biomarkers and their intrinsic mechanisms in clinical cases and experimental models of TBI has increased in recent years. According to this, we hypothesize that such immunolabeling compilation for assessment of BBB integrity could be used as a supplemental diagnostic tool for BBB disruption in cases of TBI for forensic and neuropathological examination. We evaluated the expression of fibrinogen, albumin, anti-CD34 (endothelium) and anti-GFAP, using immunohistochemical staining and Mallory's trichrome method for histological staining of the brain tissue of the analyzed population, which was conducted during postmortem examinations evaluating a structural and functional disruption of BBB in an early phase of TBI. The study was performed using cases (n = 15) of severe and fatal head injury and control cases (n = 15) of sudden death in the mechanism of cardiopulmonary failure. In our study, we documented that plasma protein immunohistochemical staining could provide a valuable additional marker with its potential to evaluate and confirm during postmortem examination that the deceased was subjected to functional breakdown of BBB in the early phase of TBI.