Bilateral middle cerebral artery infarction associated with traumatic common carotid artery dissection: A case report and review of literature

Abstract Traumatic common carotid artery dissection is very rare, and although it is associated with mild symptoms, it can sometimes be fatal. Therefore, careful examination of common carotid artery dissection and additional pathological examination as appropriate are important during the autopsy of...

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Bibliographic Details
Published in:Forensic science international 2014-03, Vol.236 (C), p.e1-e4
Main Authors: Chiba, Fumiko, Makino, Yohsuke, Motomura, Ayumi, Inokuchi, Go, Ishii, Namiko, Torimitsu, Suguru, Sakuma, Ayaka, Nagasawa, Sayaka, Saito, Hisako, Yajima, Daisuke, Hayakawa, Mutsumi, Iwase, Hirotaro
Format: Article
Language:English
Subjects:
Accidents, Traffic
Alcoholic Intoxication - complications
Antemortem images
Arteries
Autopsies
Blood clots
Carotid arteries
Carotid Artery Injuries - pathology
Carotid Artery Thrombosis - pathology
Carotid Artery, Common - diagnostic imaging
Carotid Artery, Common - pathology
Cerebral infarction
Consciousness
Death
Diagnosis
Dissection
Embolisms
Fatalities
Female
Forensic Pathology
Forensic sciences
HIV
Human immunodeficiency virus
Humans
Infarction
Infarction, Middle Cerebral Artery - diagnostic imaging
Infarction, Middle Cerebral Artery - pathology
Injuries
Medical imaging
Middle Aged
Middle cerebral artery
Pathology
Strangulation
Tomography, X-Ray Computed
Trauma
Traumatic common carotid artery dissection
Tunica Intima - pathology
Tunica Media - pathology
Veins & arteries
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Summary:Abstract Traumatic common carotid artery dissection is very rare, and although it is associated with mild symptoms, it can sometimes be fatal. Therefore, careful examination of common carotid artery dissection and additional pathological examination as appropriate are important during the autopsy of traumatic death patients. A 60-year-old previously healthy drunken woman was run over. She had remained unconscious shortly after the accident, and 15 h later, emerging bilateral cerebral infarction was confirmed using brain computed tomography. Despite conservative management, she died 4 days after the injury due to multiple chest traumas and broad cerebral infarction. A medico-legal autopsy was conducted. According to the autopsy results, microscopically identified common carotid artery dissections with thrombus formation were considered the cause of infarction. In the present case, macroscopic common carotid artery lesions were relatively mild, and this made diagnosis difficult. However, the correct diagnosis was achieved by a combined analysis of the antemortem images and autopsy results. Thus, in such cases, a combined comprehensive analysis of autopsy results and antemortem clinical images is important to determine the exact cause of death.
ISSN:0379-0738
1872-6283
DOI:10.1016/j.forsciint.2014.01.003