Three Case Reports of Sudden Death as a Result of Hemorrhage Related to Vascular Malformation of Brain
DOI:
https://doi.org/10.17986/blm.200381490Keywords:
arteriovenous malformation, suddent death, autopsyAbstract
Vessel abnormalities seen in the central nervous system are the result of vascular malformations in brain and can be observed in various forms like little lesions determined at the autopsy to lesions leading to fatal intracranial haemorrhages. Our study includes three sudden death cases which were autopsied between 1998-2003 at the Morgue Specialization Department of the Council of Forensic Medicine. Cause of death was subarachnoidal and intracerebral haemorrhage due to vascular malformation in brain for all three cases. Age of our cases were between 16 to 29, two of them were male, and one was female. Macroscopic examination revealed softening of brain and cerebellum consistency, and inner parenchymal, intraventricular and subarachnoid hemorrhage areas with localisation on right parietal lobe in one case, and with localisation on cerebellum and brain stem in two cases. Microscopic examination showed folded vessel structures, connected and back to back with each other in brain parenchyma. Some of the vessels were thin walled and venous, but most of them were composed of ambigious vessel structures. Neural tissue could be differentiated between vessels. According to macroscopic and microscopic findings, the cases were considered as arteriovenous malformation, and related were subarachnoid and intracerebral hemorrhage. Death occured as pathological cerebral hemorrhage related with vascular malformation. These cases with various clinical progress, and occasionally clinically asyptomatic, can be seen as a cause of sudden death in our forensic medical practice. The aim of this case report is to emphasize the medical and legal importance of autopsy in uncertainty of death cause.
Key words: Arteriovenous malformation, sudden death, autopsy
Downloads
References
Robbins S, Cotran R, Kumar V(eds) The Nervous System. In Basic Pathology. Seventh edition W.B. Saunders Company. Burns D, Kumar V. 2003, 809-851.
Kilic T, Pamir N, Küllü S, Eren F, Özek MM, Black P. Expression of structural proteins and angiogenic factors in cereb- rovascukar anomalies. Neurosurgery 2000;46:1179-2000. DOI: https://doi.org/10.1097/00006123-200005000-00032
Ondra S, Troupp H, George E et al: The natural history of symptomatic arteriovenous malformations of the brain: a 24 year follow-up assesment. J Neurosurg, 1990; 73: 387-391. DOI: https://doi.org/10.3171/jns.1990.73.3.0387
Mandybur TI, Nazek MN. Cerebral arteriovenous malformations: A detailed morphological and immunhistochemi- cal study using actin. Arch Pathol Lab Med, 1990; 114:970-3.
Graham D, Lantos P (eds) Trauma Chapter 14 in Greenfield’s Neuropathology. Seventh edition.The Oxford University Press. Graham DI, Gennarelli TA, McIntosh TK. 2002;823-898.
Davis RL, Robertson DM. Circulatory disorders and their effects on the brain chapter 15 in textbook of neuropathology third ed . Williams & Wilkins , Baltimore, Maryland; 1997; 715-822.
Berman MF, Sciacca R, Spellman JP et al. The epidemiology of brain arteriovenous malformations. Neurosurgery, 2000; 47:389-395. DOI: https://doi.org/10.1097/00006123-200008000-00023
Karhunen PJ, Penttila A, Erkinjunni T. Arteriovenous malformation of the brain :imaging by postmortem angiography. Forensic Sei Int 1990; 48(1):9-19. DOI: https://doi.org/10.1016/0379-0738(90)90267-3
Lobato RD, Perez C, Rivas JJ, Cordobés F. Clinical, radiological, and pathological spectrum of angiographically occult intracranial vascular malformations. Analysis of 21 cases and review of the literature. J Neurosurg 1988, 518-31. DOI: https://doi.org/10.3171/jns.1988.68.4.0518
Downloads
Published
Issue
Section
License
Copyright (c) 2003 Işıl Pakiş- Arzu Akçay Turan- Ferah Karayel- Aydın Sav- Gürsel Çetin
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
