Skip to main content
Log in

Hippocampal pathology in fatal non-missile human head injury

  • Regular Papers
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Summary

The hippocampus has been known to be involved in fatal non-missile human head injury, although detailed histopathology of this lesion has yet to be described. This report documents the frequency and distribution of hippocampal damage in a consecutive series of 112 fatal human non-missile head injuries. Damage to the hippocampus was noted in 94 cases (84%). Lesions always involved the CA1 subfield and were bilateral in 70 cases.

Other subfields of the hippocampus were involved less frequently. Lesions were focal in the majority of cases (58%). Pathological evidence of high intracranial pressure was present in 86% of the cases. Hypoxic brain damage in other regions of the brain was present in 74% of cases. Thus, the hippocampus is frequently damaged in fatal non-missile human head injury. The pattern of this damage is similar to that observed in experimental head injury. Hypoxia and high intracranial pressure are likely to contribute to the ocurrence of human traumatic hippocampal damage but other mechanisms, such as excitotoxicity, are likely to be operative.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams JH, Graham DI (1976) The relationship between ventricular fluid pressure and the neuropathology of raised intracranial pressure. Neuropathol Appl Neurobiol 2:323–332

    Google Scholar 

  2. Adams JH, Doyle D, Graham DI, Lawrence AE, McLellan DR, Gennarelli TA, Pastuszko M, Sakamoto T (1985) The contusion index: a reappraisal in human and experimental non-missile head injury. Neuropathol Appl Neurobiol 11:299–308

    Google Scholar 

  3. Adams JH, Graham DI, Scott G, Parker LS, Doyle D (1980) Brain damage in non-missile head injury. J Clin Pathol 33:1132–1145

    Google Scholar 

  4. Becker DP, Miller JD, Ward JD, Greenberg RP, Young HF, Sakalas R (1977) The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47:491–502

    Google Scholar 

  5. Brierey JB, Graham DI (1984) Hypoxia and vascular disorders of the central nervous system. In: Adams JH, Corsellis JAN, Duchen LW (eds) Greenfield's neuropathology, 4th edn. Edward Arnold, London, pp 125–207

    Google Scholar 

  6. Brown AW (1977) Structural abnormalities in neurons. J Clin Pathol [Suppl] (R Coll Pathol) 11:155–169

    Google Scholar 

  7. Bullock R, Butcher S, McCulloch J (1990) Changes in extracellular glutamate concentration after acute subdural hematoma in the rat-evidence for an “excitotoxic” mechanism? Acta Neurochir Suppl (Wien) 51:274–276

    Google Scholar 

  8. Cortez SC, McIntosh TK, Noble LJ (1989) Experimental fluid percussion brain injury: vascular disruption and neuronal and glial alterations. Brain Res 482:271–282

    Google Scholar 

  9. Duhaime AC, Ross DT (1990) Degeneration of hippocampal CA1 neurons following transient ischemia due to raised intracranial pressure: evidence for a temperature dependent excitotoxic process. Brain Res 512:169–174

    Google Scholar 

  10. Faden AI, Demediuk P, Panter SS, Vink R (1989) The role of excitatory amino acids and NMDA receptors in traumatic brain injury. Science 244:798–800

    Google Scholar 

  11. Graham DI, Adams JH, Doyle D (1978) Ischemic brain damage in fatal non-missile head injuries. J Neurol Sci 39:213–234

    Google Scholar 

  12. Graham DI, Lawrence AE, Adams JH, Doyle D, McLellan DR (1987) Brain damage in non-missile head injury secondary to high intracranial pressure. Neuropathol Appl Neurobiol 13:209–217

    Google Scholar 

  13. Graham DI, Lawrence AE, Adams JH, Doyle D, McLellan DR (1988) Brain damage in fatal non-missile head injury without high intracranial pressure. J Clin Pathol 41:34–37

    Google Scholar 

  14. Graham DI, Ford I, Adams JH, Doyle D, Teasdale GM, Lawrence AE, McLellan DR (1989) Ischaemic brain damage is still common in fatal non-missile head injury. J Neurol Neurosurg Psychiatry 52:346–350

    Google Scholar 

  15. Inglis FM, Bullock R, Chen MH, Graham DI, Miller JD, McCulloch J (1990) Ischaemic brain damage associated with tissue hypermetabolism in acute subdural hematoma: reduction by a glutamate antagonist. Acta Neurochir Suppl (Wien) 51:277–279

    Google Scholar 

  16. Jenkins LW, Lyeth BG, Lewelt W, Moszynski K, DeWitt DS, Balster RL, Miller LP, Clifton GL, Young HF, Hayes RL (1988) Combined pre-trauma scopolamine and phencyclidine attenuate post-traumatic increased sensitivity to delayed secondary ischemia. J Neurotrauma 5:275–287

    Google Scholar 

  17. Jenkins LW, Moszynski K, Lyeth BG, Lewelt W, DeWitt DS, Allen A, Dixon CE, Povlishock JT, Majewski TJ, Clifton GL, Young HF, Becker DP, Hayes RL (1989) Increased vulnerability of the mildly traumatized rat brain to cerebral ichemia: the use of controlled secondary ischemia as a research tool to identify common or different mechanisms contributing to mechanical and ischemic brain injury. Brain Res 477:211–224

    Google Scholar 

  18. Katayama Y, Cheung MK, Alves A, Becker DP (1989) Ion fluxes and cell swelling in experimental traumatic brain injury: the role of excitatory amino acids. In: Hoff JT, Betz AL (eds) Intracranial pressure, vol VII. Springer-Verlag, Berlin, pp 584–588

    Google Scholar 

  19. Kotapka MJ, Gennarelli TA, Graham DI, Adams JH (1991) Lack of relationship between hippocampal cell loss and ICP after experimental head injury. In: Avezaat CJJ, et al (eds) Intracranial pressure, vol VIII. Springer-Verlag, Berlin (in press)

    Google Scholar 

  20. Kotapka MJ, Gennarelli TA, Graham DI, Adams JH, Thibault LE, Ross DT, Ford I (1991) Selective vulnerability of hippocampal neurons in acceleration-induced experimental head injury. J Neurotrauma 8:247–258

    Google Scholar 

  21. Lorrente de No R (1934) Studies on the structure of the cerebral cortex II: continuation of the study of the Ammonic system. J Psychol Neurol 46:113–177

    Google Scholar 

  22. Ng T, Graham DI, Adams JH, Ford I (1989) Changes in the hippocampus and the cerebellum resulting from hypoxic insults: frequency and distribution. Acta Neuropathol 78:438–443

    Google Scholar 

  23. Pulsinelli WA (1985) Selective neuronal vulnerability: morphological and molecular characteristics. Prog Brain Res 63:29–37

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kotapka, M.J., Graham, D.I., Adams, J.H. et al. Hippocampal pathology in fatal non-missile human head injury. Acta Neuropathol 83, 530–534 (1992). https://doi.org/10.1007/BF00310031

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00310031

Key words

Navigation