title: Brain-stem laceration and blunt rupture of thoracic aorta:  is the intrapleural bleeding postmortem in origin?: an autopsy study.
abstract: Some of the fatally injured car occupants could have had both blunt rupture of thoracic aorta with great amount of intrapleural blood, and pontomedullar laceration of brain-stem as well, with both injuries being fatal. The aim of this study was to answer if all intrapleural bleeding in these cases was antemortem, or the bleeding could also be partially postmortem. We observed the group of 66 cases of blunt aortic rupture: 21 case with brain-stem laceration, and 45 cases without it. The average amount of intrapleural bleeding in cases without brain-stem laceration (1993 ± 831 mL) was significantly higher than in those with this injury (1100 ± 708 mL) (t = 4.252, df = 64, P = 0.000). According to our results, in cases of the thoracic aorta rupture with concomitant brain-stem laceration, the amount of intrapleural bleeding less than 1500 mL, should be considered mostly as postmortem in origin, and in such cases, only the brain-stem injury should be considered as cause of death.
authors.affiliation: Institute of Forensic Medicine, School of Medicine, University of Belgrade, Serbia. vladinmejl@yahoo.com
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zivković
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolić
authors.forename: Dragan
authors.initials: D
authors.lastname: Babić
authors.forename: Fehim
authors.initials: F
authors.lastname: Juković
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000293:injuries* / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology; D001933:Brain Stem / Q000293:injuries* / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006491:Hemothorax / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D012189:Retrospective Studies; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult