title: Toothpaste artifact of the spinal cord observed in a victim of traffic accident who died of pulmonary thrombotic embolism after laminectomy.
abstract: Toothpaste artifact of the spinal cord is generally known as artificial and morphological change in the field of neuropathology. It is considered that while the spinal cord is pressed on local parts with some solid bodies, the inner spinal tissue pressed penetrates into the weak vicinity of pressed parts and consequently pencil-shaped morphological change, toothpaste artifact, occurs. We report an autopsy case with toothpaste artifact of the spinal cord. A 77-year-old man, who was a front-seat passenger and was injured to the vertebra in a traffic accident, complained suddenly of dyspnea and precordial oppression during a rest on bed in a hospital 18 days after laminectomy, and he died of pulmonary embolism originated in thrombi in the deep veins of lower extremities. The toothpaste artificial change of spinal cord was microscopically observed at the near site of laminectomy. Slight bleeding was observed in a margin of the slipped area, but there was no reactive change. In present case, external compression of spinal cord which occurred accidentally during the period after the operation or at cardiopulmonary resuscitation seems to have caused the toothpaste artifact.
authors.affiliation: Department of Legal Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Junichi
authors.initials: J
authors.lastname: Furumiya
mesh_terms: D000063:Accidents, Traffic; D000368:Aged; D016477:Artifacts; D049429:Forensic Pathology; D006801:Humans; D007796:Laminectomy; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology*; D013117:Spinal Cord Compression / Q000150:complications; D020246:Venous Thrombosis / Q000150:complications*