{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:54:05Z","timestamp":1790610845926,"version":"4.1.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012352","name":"Universit\u00e0 degli Studi di Milano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Forensic Sci Med Pathol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background in forensic toxicology, the detection of pharmacologically active exogenous substances is routinely performed. Interpretation of analyte concentrations must consider multiple variables, markedly affected by diffusion and degradation. These factors complicate toxicological assessment and have stimulated interest in alternative substrates. Objective: To assess the toxicological informativeness of cerebrospinal fluid (CSF) through comparison with standard post-mortem matrices, and to investigate whether quantitative relationships exist between CSF and femoral blood concentrations of cocaine and benzoylecgonine. Methods: CSF and standard toxicological matrices were collected from 10 forensic cases and three controls. All specimens underwent solid-phase extraction followed by HPLC-Orbitrap mass spectrometry for detection and quantification of cocaine, benzoylecgonine, and other relevant substances. Results: Cocaine and benzoylecgonine were consistently detected in cerebrospinal fluid whenever present in standard matrices, indicating their passage across the blood\u2013brain barrier and supporting CSF as a reliable alternative post-mortem matrix. However, the limited sample size and absence of temporal or clinical information precluded robust quantitative interpretation, highlighting the need for larger studies to clarify pharmacokinetic relationships. Conclusion: Cocaine and benzoylecgonine are detectable in cerebrospinal fluid when present in peripheral blood, but no stable proportional relationship allowing quantitative extrapolation from CSF to femoral blood could be established.<\/jats:p>","DOI":"10.1007\/s12024-026-01312-8","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:28:52Z","timestamp":1785162532000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cerebrospinal fluid as a post-mortem toxicological matrix: qualitative reliability and quantitative limitations in a cocaine-positive cases"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-5121","authenticated-orcid":false,"given":"Graziano Domenico Luigi","family":"Crudele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-0708","authenticated-orcid":false,"given":"Lorenzo","family":"Franceschetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Cecalupo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-6771","authenticated-orcid":false,"given":"Alberto","family":"Amadasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-6815","authenticated-orcid":false,"given":"Domenico","family":"Di Candia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"issue":"4","key":"1312_CR1","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1007\/s12024-023-00709-z","volume":"20","author":"GMM Abdelaal","year":"2024","unstructured":"Abdelaal GMM, Hegazy NI, Etewa RL, Elmesallamy GEA. Postmortem redistribution of drugs: a literature review. Forensic Sci Med Pathol. 2024;20(4):1483\u201390. . https:\/\/doi.org\/10.1007\/s12024-023-00709-z","journal-title":"Forensic Sci Med Pathol"},{"key":"1312_CR2","doi-asserted-by":"publisher","unstructured":"Engelhart DA, Jenkins AJ. Comparison of drug concentrations in postmortem cerebrospinal fluid and blood specimens. J Anal Toxicol. 2007 Nov-Dec;31(9):581\u20137. https:\/\/doi.org\/10.1093\/jat\/31.9.581","DOI":"10.1093\/jat\/31.9.581"},{"issue":"1","key":"1312_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.nbd.2003.12.016","volume":"16","author":"P Ballabh","year":"2004","unstructured":"Ballabh P, Braun A, Nedergaard M. The blood-brain barrier: an overview: structure, regulation, and clinical implications. Neurobiol Dis. 2004;16(1):1\u201313. . https:\/\/doi.org\/10.1016\/j.nbd.2003.12.016","journal-title":"Neurobiol Dis"},{"key":"1312_CR4","unstructured":"European Union Drugs Agency (EUDA). 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This article does not contain any studies with (living) human participants or animals performed by any of the authors. The subjects involved in this study underwent a judicial autopsy in order to identify the cause of death. In Italy, forensic autopsies and related post-mortem investigations that are performed within the framework of a judicial proceeding (either upon prosecutorial order or under the authority of the judiciary) do not require approval by an Institutional Review Board (IRB) or Ethics Committee. Such procedures are conducted under the provisions of the Italian Code of Criminal Procedure (Articles 359\u2013360, 116, 224 et seq.), which govern medico-legal examinations performed for judicial purposes. The case concerns thirteen deceased subjects within a legal\/forensic context. Prosecutors opened an investigation, and a judicial autopsy was ordered. Therefore, ethics committee approval was not required. The investigation was conducted in accordance with the principles set forth in the Declaration of Helsinki (1975, as revised in 2013).","order":1,"name":"Ethics","label":"Institutional review board statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This study was conducted in accordance with international ethical guidelines, including the Declaration of Helsinki. Informed consent for participation is not required as part of a public verdict and per local legislation on deceased subjects [Italian Legislative Decree 10 August 2018, n. 101, Provisions for the implementation of national legislation to the provisions of Regulation (EU) 2016\/679 of the European Parliament and of the Council of April 27, 2016, on the protection of individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive 95\/46\/EC].","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}