title: Cerebellar contusions as a possible cause of traumatic basal subarachnoid hemorrhage: a case report.
abstract: Traumatic basal subarachnoid hemorrhage (TBSAH) is infrequent but of forensic neuropathological importance because of its high mortality and complex causal mechanisms. The source of the hemorrhage is most frequently identified in the vertebro-basilar arteries but often cannot be identified in these arteries. We present a case of TBSAH possibly originating from hemorrhagic cerebellar contusions due to fist blows to the neck. A 35-year-old woman, who was punched on the right side of the neck, became unconscious about 20 min later and died. Autopsy demonstrated a massive subarachnoid hemorrhage at the base of the brain, with blood clots attached to the right lower surface of the cerebellum. No tear was detected in the vertebro-basilar vessels, but there were hemorrhagic cerebellar contusions beneath the blood clots as a possible source of TBSAH. The site of impact to the neck suggested the cerebellar contusions to be a coup injury due to hard blows.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Takaki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tomomi
authors.initials: T
authors.lastname: Michiue
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maeda
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology*; D002423:Cause of Death; D017809:Fatal Outcome; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D014947:Wounds and Injuries; D014949:Wounds, Nonpenetrating / Q000150:complications*