Detection of ruptured cerebral bridging veins at autopsy.
Subdural hematomas (SDH) are a frequent autopsy finding in victims of closed head injuries. About 2/3 of the cases in our own massive SDH series had brain contusions as a cause of bleeding. In about 1/3 of the cases, SDH resulted from ruptured vessels of the brain surface in the absence of contusions. Our experience has shown that such an "isolated" SDH may be expected in about 5% of fatal blunt head injuries. A technique is presented to detect bridging vein leakage before there is any risk of artificial damage. After sawing through the skull in the fronto-occipital plane and cutting through the upper half of the brain together with the calvarium, approximately 5-10 ml of barium sulfate are instilled into the superior sagittal sinus by a balloon catheter at low pressure, and X-rays are taken. If there is extravasation, the rupture is visible before further preparation.
Maxeiner
H
H
Institute of Forensic Medicine, University Medical Center Benjamin Franklin, Free University of Berlin, Germany.
D001344:Autopsy / Q000379:methods*; D001466:Barium Sulfate; D002404:Catheterization; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000293:injuries*; D003287:Contrast Media; D006259:Craniocerebral Trauma / Q000150:complications*; D006408:Hematoma, Subdural / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D011859:Radiography; D012421:Rupture
D003287:Contrast Media; D001466:Barium Sulfate