W J Schulz-Schaeffer1, U Dillmann2, K Faßbender2, A Wrede3. 1. Institut für Neuropathologie, Klinikum der Universität des Saarlandes, Kirrberger Str. 100, Gebäude 90.3, 66421, Homburg/Saar, Deutschland. Walter.Schulz-Schaeffer@uks.eu. 2. Neurologische Klinik, Klinikum der Universität des Saarlandes, Homburg/Saar, Deutschland. 3. Institut für Neuropathologie, Klinikum der Universität des Saarlandes, Kirrberger Str. 100, Gebäude 90.3, 66421, Homburg/Saar, Deutschland.
Abstract
BACKGROUND: In assuring the quality of the healthcare system, it is the intention of healthcare politics to raise the number of clinical autopsies. OBJECTIVE: What are the requirements of clinical neurologists for neuroautopsies and how can the post-mortem examiner cope with these requests? METHODS: Discussion on how the questions that arise with the most relevant neurological disease groups can be solved by post-mortem examination. RESULTS: The diagnostics of inflammatory, inflammatory demyelinating and demyelinating brain diseases, neurodegenerative diseases and neuromuscular diseases as well as central nervous system tumors necessitate the removal of specific brain regions, specific examination techniques, immunohistochemical investigations or specific samples taken for biochemical, molecular pathological or genetic investigations according to international published consensus criteria. It is the first priority in post-mortem examinations to use all possible options and appraisals to identify patients with the aforementioned neurological diseases or suspected diseases early enough during the autopsy process that the tissue sampling, necessary for diagnosing the assumed diseases, will take place. CONCLUSION: Demands made on neuropathological investigations have increased tremendously, because of rapid progress in understanding chronic neurological diseases and the requirements of consensus criteria. To cope with expectations on neuropathological post-mortem investigations, a close collaboration should be established between clinical neurologists, post-mortem examiners and neuropathologists.
BACKGROUND: In assuring the quality of the healthcare system, it is the intention of healthcare politics to raise the number of clinical autopsies. OBJECTIVE: What are the requirements of clinical neurologists for neuroautopsies and how can the post-mortem examiner cope with these requests? METHODS: Discussion on how the questions that arise with the most relevant neurological disease groups can be solved by post-mortem examination. RESULTS: The diagnostics of inflammatory, inflammatory demyelinating and demyelinating brain diseases, neurodegenerative diseases and neuromuscular diseases as well as central nervous system tumors necessitate the removal of specific brain regions, specific examination techniques, immunohistochemical investigations or specific samples taken for biochemical, molecular pathological or genetic investigations according to international published consensus criteria. It is the first priority in post-mortem examinations to use all possible options and appraisals to identify patients with the aforementioned neurological diseases or suspected diseases early enough during the autopsy process that the tissue sampling, necessary for diagnosing the assumed diseases, will take place. CONCLUSION: Demands made on neuropathological investigations have increased tremendously, because of rapid progress in understanding chronic neurological diseases and the requirements of consensus criteria. To cope with expectations on neuropathological post-mortem investigations, a close collaboration should be established between clinical neurologists, post-mortem examiners and neuropathologists.
Authors: Thomas J Montine; Creighton H Phelps; Thomas G Beach; Eileen H Bigio; Nigel J Cairns; Dennis W Dickson; Charles Duyckaerts; Matthew P Frosch; Eliezer Masliah; Suzanne S Mirra; Peter T Nelson; Julie A Schneider; Dietmar Rudolf Thal; John Q Trojanowski; Harry V Vinters; Bradley T Hyman Journal: Acta Neuropathol Date: 2011-11-20 Impact factor: 17.088
Authors: S S Mirra; A Heyman; D McKeel; S M Sumi; B J Crain; L M Brownlee; F S Vogel; J P Hughes; G van Belle; L Berg Journal: Neurology Date: 1991-04 Impact factor: 9.910
Authors: I Litvan; Y Agid; D Calne; G Campbell; B Dubois; R C Duvoisin; C G Goetz; L I Golbe; J Grafman; J H Growdon; M Hallett; J Jankovic; N P Quinn; E Tolosa; D S Zee Journal: Neurology Date: 1996-07 Impact factor: 9.910
Authors: I G McKeith; D W Dickson; J Lowe; M Emre; J T O'Brien; H Feldman; J Cummings; J E Duda; C Lippa; E K Perry; D Aarsland; H Arai; C G Ballard; B Boeve; D J Burn; D Costa; T Del Ser; B Dubois; D Galasko; S Gauthier; C G Goetz; E Gomez-Tortosa; G Halliday; L A Hansen; J Hardy; T Iwatsubo; R N Kalaria; D Kaufer; R A Kenny; A Korczyn; K Kosaka; V M Y Lee; A Lees; I Litvan; E Londos; O L Lopez; S Minoshima; Y Mizuno; J A Molina; E B Mukaetova-Ladinska; F Pasquier; R H Perry; J B Schulz; J Q Trojanowski; M Yamada Journal: Neurology Date: 2005-10-19 Impact factor: 9.910