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Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus

Hypostasis and hemorrhagic lesion in brain in 35-year-old deceased woman (case 1).A. CT scan obtained 8 hours and 35 minutes after death shows obscure hypostasis in dorsal superior sagittal sinus (arrowhead) in case 1. Linear and curving high density lesions are present along falx cerebri and cerebral sulcus (arrows). B. Subsequent autopsy reveals diffuse subarachnoid hemorrhage. CT = computed tomography
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Figure 1: Hypostasis and hemorrhagic lesion in brain in 35-year-old deceased woman (case 1).A. CT scan obtained 8 hours and 35 minutes after death shows obscure hypostasis in dorsal superior sagittal sinus (arrowhead) in case 1. Linear and curving high density lesions are present along falx cerebri and cerebral sulcus (arrows). B. Subsequent autopsy reveals diffuse subarachnoid hemorrhage. CT = computed tomography

Mentions: In case 1, high density was observed in the dorsal SSS and was initially considered a normal postmortem change (Fig. 1A, arrowhead). However, linear and curving high-density lesions were identified along the falx cerebri and cerebral sulcus (Fig. 1A, arrows); therefore, subarachnoid hemorrhage or subdural hematoma was suspected. An autopsy revealed diffuse subarachnoid hemorrhage (Fig. 1B). Potentially, high-density areas in the extra-axial brain space may be misinterpreted as normal postmortem changes when the high-density region is adjacent to an area of hypostasis. When the location of a high-density area matches that of the superficial cerebral veins, postmortem intravascular coagulation may be present.


Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Hypostasis and hemorrhagic lesion in brain in 35-year-old deceased woman (case 1).A. CT scan obtained 8 hours and 35 minutes after death shows obscure hypostasis in dorsal superior sagittal sinus (arrowhead) in case 1. Linear and curving high density lesions are present along falx cerebri and cerebral sulcus (arrows). B. Subsequent autopsy reveals diffuse subarachnoid hemorrhage. CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499544&req=5

Figure 1: Hypostasis and hemorrhagic lesion in brain in 35-year-old deceased woman (case 1).A. CT scan obtained 8 hours and 35 minutes after death shows obscure hypostasis in dorsal superior sagittal sinus (arrowhead) in case 1. Linear and curving high density lesions are present along falx cerebri and cerebral sulcus (arrows). B. Subsequent autopsy reveals diffuse subarachnoid hemorrhage. CT = computed tomography
Mentions: In case 1, high density was observed in the dorsal SSS and was initially considered a normal postmortem change (Fig. 1A, arrowhead). However, linear and curving high-density lesions were identified along the falx cerebri and cerebral sulcus (Fig. 1A, arrows); therefore, subarachnoid hemorrhage or subdural hematoma was suspected. An autopsy revealed diffuse subarachnoid hemorrhage (Fig. 1B). Potentially, high-density areas in the extra-axial brain space may be misinterpreted as normal postmortem changes when the high-density region is adjacent to an area of hypostasis. When the location of a high-density area matches that of the superficial cerebral veins, postmortem intravascular coagulation may be present.

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus