The forensic medical evaluation of the changes in the cerebral tissue in the case of sudden death from alcoholic cardiomyopathy

Abstract

This article presents the results of the retrospective analysis of the protocols of forensic medical autopsies and histological studies of the cerebral tissues together with the data obtained by their statistical treatment. The objective of present work was to study and evaluate the structural changes in the cerebral tissues associated with sudden cardiac death from alcoholic cardiomyopathy. It was shown that the morphological changes in the endothelial lining of the microcirculatory bed of the cerebral tissue can be a consequence of both the direct cytotoxic action of ethanol or its metabolites and the influence of cellular modulators liberation of which results in enhanced vascular permeability associated with trophic disturbances in the tissue. These changes provide a substrate for the development of the dystrophic and necrobiotic processes in the main structural components of the organ in question. The clustering of glial cells around atrophic neutrons or instead of the dead ones in the brain as well as around the microcysts of the cerebral tissue as a compensatory response to the lesion can be in its turn considered as a pathognomonic sign of chronic alcoholic intoxication. The severe dystrophic and destructive processes proceeding in the main components of the histohematological barrier revealed in the cerebral tissue as a result of the present analysis are believed to reflect the toxic action of ethanol and/or its metabolites that play an important role in the development of dyscirculatory disorders responsibly for cerebral tissue hypoxia.