The State of the Structure of the Brain Cortex at Different Times of the Postmortal Period after Massive Blood Loss and Blood Loss Complicated by Hemorrhagic Shock

Abstract

Determine the time of death based on these characteristics. Aims: The aim of the study was to identify the features of changes in the structure of the cerebral cortex in different periods of the post - mortem period after massive blood loss and blood loss complicated by hemorrhagic shock, and to determine the age of death based on these data. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine and Department of Forensic Medicine 2020 between. Methodology: The structures of the cortex from the Brodman sixth field of the large hemispheres of the brain were studied from 73 corpses of individuals who died from massive blood loss (MB) - 61 and blood loss complicated by hemorrhagic shock -12. The study of corpses with MB (group 1) was carried out in the period: 6-8 h (26), 8-10 h (6), 10-12 h (4), 12-14 h (6), 14-16 h ( 12), 16-24 h (5), 24-28 h (2) postmortem period. Research of corpses after hemorrhagic shock (group 2) were carried out after 6-8 hours (3), 12-14 (3), 18-20 (2), 24-28 (4). Histological preparations of the brain were first examined qualitatively, then quantitatively. Quantitative study of structures was carried out by the point method according To G. G. Avtandilov, the digital material was statistically processed by the Student – Fisher method. Results: Thus, at death from massive blood loss, as the post-mortem period increases, there is an increase in structural changes in cortical neurons,as well as an expansion of  pericellular space. The vascular component of the cerebral cortex is also involved in destructive processes associated with an increase in the postmortem period, and an increase in perivascular spaces is observed. Conclusion: Comparative analysis of the data obtained showed that in the postmortem period after hemorrhagic shock (group 2), destructive changes in the cerebral cortex appear earlier and are more pronounced than in the case of death from massive blood loss (group 1). Similar expansion of perineuronal and perivascular spaces in the cerebral cortex reflects the persistence of thanatogenesis manifestations in different periods of the post-mortal period after death from massive blood loss and hemorrhagic shock.