Further evidence for a lack of reliability in the histologic ageing of bruises-an autopsy study

Abstract

Objective: Two adult males are reported whose deaths occurred 19 h and five days, respectively, after blunt craniocervical injury. In case 1, although interstitial haemorrhage was present in four samples of bruised paravertebral muscle, only one sample had an early acute inflammatory cell infiltrate. In case 2 microscopic examination of two bruises showed haemorrhage into muscle and adipose tissue, again with no significant inflammatory reaction and only occasional haemosiderin-containing macrophages. These cases demonstrate considerable variability in histological response to blunt trauma in human tissues and suggest that samples taken from areas of extravasated blood in a bruise may not manifest the type of vital reaction that occurs in areas where there has been direct tissue damage. As the presence and/or degree of inflammation may be influenced by the site of tissue sampling, interpretations of the age of a bruise based on histologic reaction should, therefore, be undertaken with caution.