Morphological changes of cerebral ventricular wall in traumatic brain injury evaluated via large histological specimens.

Large brain specimens were prepared from 50 head-injured and 50 non-head-injured cases that underwent medicolegal autopsy to critically examine the morphological changes in the periventricular tissue caused by injury to the head. Hemorrhagic damage to the ventricular wall was observed in 30 (60%) of the head-injury cases but was not observed in any of the non-head injured cases. Of 14 cases with only wounds to the scalp, five cases (35.7%) had ventricular wall damage. Of 40 cases in which death occurred within 24 h after injury, 25 (62.5%) showed ventricular wall damage. Of five cases of dying more than 24 h post-injury, only one revealed ventricular wall damage. This ventricular wall damage was frequently detected in the posterior (46%) and anterior horns (19%) of the lateral ventricle, near the attachment of the choroid plexus (19%). These morphological changes are considered primary damage, formed at the moment of impact in that concomitant hemorrhagic damage to the ventricular wall was also observed in all immediate death cases. Accordingly, detection of ventricular wall damage is considered a reliable means for deducing the occurrence of traumatic injury even in the cases where death occurs soon after injury.