Diagnostics of the cause of aneurism rupture in case of basal subarachnoid hemorrhage: a rare case report
- 作者: Veselkina O.V.1,2, Plis S.S.1, Khutornoy N.V.3, Shishkina L.V.4, Prazdnikov E.N.3, Klevno V.A.1
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隶属关系:
- Moscow Regional Research and Clinical Institute
- Russian Centre of Forensic Medical Expertise, Ministry of Health of the Russia
- Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
- N.N. Burdenko National Scientific and Practical Center for Neurosurgery of the Ministry of Healthcare of the Russian Federation
- 期: 卷 6, 编号 4 (2020)
- 页面: 46-53
- 栏目: 临床病例报告
- URL: https://journal-vniispk.ru/2411-8729/article/view/122424
- DOI: https://doi.org/10.19048/fm346
- ID: 122424
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Background: Basal subarachnoid hemorrhage (SAH) caused by rupture of intracranial aneurysms usually has non-traumatic etiology. However, head injury shortly before death can start legal case, even if aneurysm was found. In such cases, forensic pathologists have to decide on the cause of the rupture and the role of the injury.
Case presentation: The article presents a rare case from forensic practice: 43 years old male dies after a head blunt trauma. The death was caused by basal SAH, which was caused by a microaneurysm rapture of the left posterior cerebral artery. The autopsy revealed external damages on the face and focal hemorrhages in soft tissues of the head and back. A detailed analysis of the morphological findings, clinical picture and circumstances was performed. The results showed that it was non-traumatic basal SAH. The cause of aneurism rupture was intracranial hypertension increased by vomiting and unusual body position shortly before the death.
Conclusion: Available published articles were studied on the causes of ruptures of pathological cerebral arteries and forensic interpretation in controversial cases. Results suggest that current recommendations should be revised. The hypothesis of the most significant sign indicating unnatural death (localization of the damage in the projection of the brain base) could not be confirmed.
作者简介
Olesya Veselkina
Moscow Regional Research and Clinical Institute; Russian Centre of Forensic Medical Expertise, Ministry of Health of the Russia
编辑信件的主要联系方式.
Email: ves-olesya@yandex.ru
ORCID iD: 0000-0002-9486-5421
SPIN 代码: 9188-2988
Assistant of the Department of Forensic Medicine
俄罗斯联邦, 1 bld 61/2, Shchepkina str. Moscow; MoscowSemyon Plis
Moscow Regional Research and Clinical Institute
Email: SSPlis.work@gmail.com
ORCID iD: 0000-0002-0232-0425
SPIN 代码: 4347-1925
Assistant of the Department of Forensic Medicine
俄罗斯联邦, MoscowNikita Khutornoy
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Email: nhutornoy@yandex.ru
ORCID iD: 0000-0003-0068-0643
SPIN 代码: 6570-2386
Ph. D. (Med.)
俄罗斯联邦, MoscowLudmila Shishkina
N.N. Burdenko National Scientific and Practical Center for Neurosurgery of the Ministry of Healthcare of the Russian Federation
Email: lshishkina@nsi.ru
ORCID iD: 0000-0001-7045-7223
SPIN 代码: 6341-2050
Ph. D. (Med.)
俄罗斯联邦, MoscowErik Prazdnikov
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Email: Enp1964@gmail.com
ORCID iD: 0000-0002-5817-0702
SPIN 代码: 2954-1200
Dr. Sci. (Med.), Prof.
俄罗斯联邦, MoscowVladimir Klevno
Moscow Regional Research and Clinical Institute
Email: vladimir.klevno@yandex.ru
ORCID iD: 0000-0001-5693-4054
SPIN 代码: 2015-6548
Dr. Sci. (Med.), Prof.
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