Neuropathological findings associated with retained lead shot pellets in aman surviving two months after a suicide attempt

We describe the neuropathological findings in a 30-year-old man who died tw o months after attempting suicide with a shotgun. We focused our study on l esions associated with retained lead shot pellets and distant therefrom, as well as lesions distant from the principal site of injury. At the sites of the retained lead shot pellets, we found macrophage proliferation and astr ocyte activation, together with axonal spheroids and signs of neuronal dama ge. In the remaining white matter wt: observed axonal swellings, astrocyte activation and rarefaction of the neuropil: regressive phenomena of the neu rons were also present. All axonal spheroids immunoreacted with antibodies against APP, alpha beta -crystallin, NF subunits and ubiquitin. Most reacti ve astrocytes were positive for GFAP and alpha beta -crystallin immunostain ing. Some neurons immunoreacting with alpha beta -crystallin were also foun d. These data indicated that an important local reaction developed at the s ites of lead shot retention, and mild signs of diffuse axonal damage were f ound throughout the brain.