Autopsy: not dead.

摘要

In his Historical Keyword piece (Nov 19, p I767),1 Michael Clark says "the autopsy has now largely been preempted by the biopsy and a raft of other less invasive techniques". He states that "many doctors have come to regard the autopsy as a crude and largely outmoded procedure" that "now has a marginal role in contemporary medical practice".As neuropathologists, we see the autopsy in a very different light. Many diseases that afflict us from the cradle to the grave involve the brain and other parts of the central nervous system. Biopsies, other than for tumour diagnosis, are done hardly, if at all, more frequently on the brain now than 50 years ago. Brain imaging techniques, although they certainly illuminate gross brain pathology in the living spectacularly well, still have only limited diagnostic use in more subtle pathological processes. The autopsy remains a cornerstone in advancing understanding of human brain diseases. This will continue to be the case in the future as new methods of treatment inneurological disease are developed that will require validation not only in life but also at autopsy. A notable example is the recently introduced vaccination treatment for Alzheimer's disease.