Use of postmortem computed tomography angiography to detect vascular injuries accompanying skull base fracture
Use of postmortem computed tomography angiography to detect vascular injuries accompanying skull base fracture
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DOI：
10.1016/j.legalmed.2016.09.008
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发表时间：
2016-11-01
期刊：
影响因子：
1.5
通讯作者：
Hirasawa, Satoshi
中科院分区：
文献类型：
--
作者：
Kuninaka, Hikaru;Takahashi, Yoichiro;Hirasawa, Satoshi
一位58岁的女性在接受上消化道钡餐检查时，不小心从活动床上滑下，头部被压在床尾和侧壁之间。她的鼻子和耳朵大量出血，随后心脏骤停，随后的心肺复苏尝试失败。作为事故调查的一部分，进行了法医解剖以查明死因。在尸检过程中，通过向双侧颈总动脉注射5%明胶钡乳剂作为不透射线的造影剂，进行了脑CT血管造影，显示造影剂进入右侧声道和蝶窦腔。考虑到尸体出现贫血，PMCTA显示血管损伤，最终确定死亡原因为右颈内动脉损伤引起的失血性休克，并伴有颅底骨折。死后CT血管造影在确认血管损伤导致出血方面发挥了重要作用，因为病变不能通过原生CT或肉眼检查完全证实。2016爱思唯尔爱尔兰有限公司版权所有。
A 58-year-old woman who had presented for upper gastrointestinal barium examination accidently slipped from the movable bed, and her head became compressed between the end of the bed and the side wall. She suffered massive bleeding from her nose and ear followed by cardiac arrest, and subsequent attempts at cardiopulmonary resuscitation failed. A medicolegal autopsy was performed to reveal the cause of death, as part of the investigation of the accident. During the autopsy, postmortem cerebral CT angiography was carried out by injection of 5% gelatin-barium emulsion as a radiopaque contrast medium into the bilateral common carotid arteries, demonstrating transudation of the contrast medium into the right acoustic meatus and the sphenoidal sinus cavity. Considering that the body appeared anemic and that PMCTA suggested vascular injuries, the cause of death was definitively determined to be hemorrhagic shock due to injuries to the right internal carotid artery, accompanied by skull base fracture. Postmortem CT angiography played an important role in confirming that the vascular injuries had been responsible for the bleeding, as the lesions could not be fully confirmed by native CT or macroscopic examination. (C) 2016 Elsevier Ireland Ltd. All rights reserved.