VARIATION OF LEPTOMENINGEAL HEMORRHAGE LOCALIZATIONS IN FETI. IMPLICATIONS IN FORENSIC EVALUATION

G. S. Drăgoi, I. Marinescu

Abstract: The relatively high frequency of leptomeningeal hemorrhage instances in premature feti initiated a research project for the anatomic evaluation of dissemination pathways and of the collection of blood in this hemorrhage episode. The variation study of leptomeningeal hemorrhage localizations, also called subarachnoidian hemorrhages, requires a dissection protocol in order to visualize the lamellar structures of the pachymeninx, of the trabecular structures of the leptomeninx and of the relief forms generated by the neuronal structures. The analysis and evaluation of leptomeningeal hemorrhage study was carried out on 20 feti aged between 8 and 32 weeks, and 4 healthy adult brains aged between 39 and 50 years for the analysis and evaluation of relief forms at the level of the diencephalon and the brain stem. Our methods aim at fixation of tissues, dissection of the scalp and opening of the brain box by cutting the calvaria opercules or by topographically cutting on planes: midsagittal, parasagittal and horizontal. We believe that anatomic localizations heterogeneity of leptomeningeal hemorrhages is dictated by the morphogenesis of the dissemination pathways and the collection of bleedings as consequences of the evolution derivatives of the primitive neuronal tube, on the one hand, and the differentiation of the neuronal structures that participate in the making of relief forms, on the other. In the forensic evaluation of deceased feti of variable prematurity degrees suffering from leptomeningeal hemorrhages the following steps are taken: evaluation of the factors generating the hemorrhage episode, the prematurity degree, whether the fetus was alive or died antepartum, intrapartum or postpartum
Keywords: dissection protocol, intracranial hemorrhage, pachimeninx, leptomeninx, prematurity