Symmetrical necrosis of the solitary tract nuclei as a contributory cause of death.
A 64-year-old man died in spite of surgery 4 days after attempting suicide. He first tried to hang himself with a rope and when the hanging did not succeed, he cut his throat with a knife. The autopsy showed four sutured cervical wounds with laryngeal wounds but without associated important vascular injury. The neuropathological study revealed two watershed-type haemorrhagic infarcts, involving the left occipital lobe and the left cerebellum. It also showed a symmetrical necrosis of solitary tract nuclei in the medullary tegmentum. Such a lesion is likely to result from sudden acute transient circulatory failure and might have played a role in the secondary autonomous cardiac and respiratory dysfunctions following a non-lethal trauma.
Lorin de la Grandmaison
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Department of Forensic Medicine and Pathology, University René Descartes, Paris-Ouest, Raymond Poincaré Hospital, Garches, France. glorin@club-internet.fr
Paraire
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F
Onaya
M
M
Gray
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F
D000368:Aged; D020203:Brain Stem Hemorrhage, Traumatic / Q000473:pathology*; D002423:Cause of Death; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000473:pathology; D009336:Necrosis; D017552:Solitary Nucleus / Q000293:injuries* / Q000473:pathology; D013405:Suicide