Chemical Biomarkers of Diffusse Axonal Injury
Authors:   The Institute of Forensic Medicine, 4, Buna Vestire Str., Iasi, Romania, ", HUNEA Iuliana ,   Gr. T. Popa",   University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, BULGARU ILIESCU Diana ,   The Institute of Forensic Medicine, Iasi, Romania; Department of Forensic Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, DAMIAN Simona Irina ,   The Institute of Forensic Medicine, Iasi, Romania; Department of Forensic Medicine,  "Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, GÎRLESCU Nona ,   The Institute of Forensic Medicine, Iasi, Romania; Department of Forensic Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, DIAC Madalina-Maria ,   The Institute of Forensic Medicine, Iasi, Romania; Department of Forensic Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, AFRĂSÂNIE Vlad Adrian ,   Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania, CIOCOIU Manuela ,   Pathophysiology Department, "Gr. T. Popa" University of Medicine and Pharmacy, 16, Universitatii Str., Iasi 700115, Romania
Published: July 2020

Cranio cerebral trauma is the most common cause of death and post-traumatic disability in people under 45 years of age. In Romania, the annual incidence shows, that for every 100,000 inhabitants, there are 300 cases of craniocerebral trauma that require specialized medical assistance. Craniocerebral traumas are the most common types of traumas encountered in current forensic practice. Research on the mechanisms of injury, the timing of head trauma and the establishment of causes of death remain relevant. Establishing the traumatic moment implies both the distinction between pre-mortem and post-mortem injuries but also considerations regarding the post-traumatic survival interval. Regarding the elucidation of the moment of occurrence of the craniocerebral trauma from the forensic point of view, a satisfactory result has not been reached so far. The classic hypothesis regarding the development of traumatic brain injuries shows that they are the result of primary traumatic injuries due to cell necrosis combined with the inflammatory brain response that causes secondary brain injuries. It was considered that post-traumatic neuronal losses are strictly due to necrosis and inflammation, and cellular apoptosis being a physiological process, does not play a role in this process. Due to recent experimental data, brain cell apoptosis has begun to be reevaluated. The pathophysiology of traumatic brain injury is far from being fully understood, with the idea that apoptosis would play an even more important role than originally thought. Specifically, damaged brain cells release neuromodulatory substances that can lead to late-onset neuronal damage long after necrotic and inflammatory brain phenomena have ceased to act. These neuronal cell losses are responsible for the development of various neurological deficits and post-traumatic sequelae.