Forensic neuropathological aspects of cerebral anoxia/ischemia and hypoxia/hypoxemia

After a short discussion of the pathophysiological, biochemical and molecul ar phenomena underlying cerebral anoxia/ischemia and hypoxia/hypoxemia, sev eral associated neuropathological alterations are described The importance of forensic neuropathology in assessing the following is stressed: 1) assessing clinically re levant disturbances of brain function and their dependence on the duration of the interruption of oxygen metabolism; 2) discriminating the morphological criteria of intravital and postmortal b rain autolysis; 3) detecting early morphological brain alterations indicative of an interru ption of oxygen metabolism in connection with problems of vitality and the specificity of these alterations; 4) estimation of survival time; 5) determining the reversibility of morphological alterations; 6) examining reflow and non-reflow-phenomena; 7) assessing the results of reflow events as well as of cardiac resuscitati on. A review of the literature suggests the shortest survival interval which le ads to routine morphological alterations is at least 3 h. The quality and q uantity of cytological and histological alterations obviously depends on th e duration and the drop of pH during reperfusion as well as on a couple of other factors. The articles in the present volume try to give descriptions of the problems on the phenomenological level as well as explanations and a nswers from a recent scientific point of view.