A history of forensic neuropathology

Abstract

Forensic neuropathology is a subspecialty of neuropathology involving those cases that may enter the criminal and civil justice courts and medico-legal death investigation systems. The cases involve trauma, poisons and diseases related to the central and peripheral nervous system. Though nervous system disorders and trauma to the brain are recorded in literature from Ancient Egypt, a better understanding of diseases, trauma and mechanisms of injury began to emerge with the writings of Renaissance surgeons with military experience. Further development came with the knowledge of cell theory and neurohistology in the nineteenth century, with the ability to examine the whole brain after fixation. Textbooks on forensic neuropathology were not produced until after World War Two. A better understanding of the pathology of neurotrauma and poisons affecting the central nervous system was developed in the twentieth century. Concepts of sudden death in epilepsy, paediatric head injury, vertebral artery trauma and hypoxic brain damage were all recognized in the last century. More recently immunohistochemistry has added to our knowledge of axonal injury. Neuroimaging, particularly CT scans have become regular tools for postmortem examinations. Recently genetic testing has become available for autopsy investigation, with applicability to vascular and thrombotic disorders as well as epilepsy. Forensic neuropathology has both an ancient and more recent history and continues to develop.