title: Death associated with an unruptured giant intracranial aneurysm.
abstract: Deaths due to or associated with unruptured giant intracranial aneurysms are extremely rare. We describe a case of a sudden death associated with an unruptured giant vertebrobasilar aneurysm in a symptomatic 18-year-old male. Post-mortem examination revealed three giant fusiform and thrombosed aneurysms (vertebrobasilar junction, internal carotid arteries), an old infarct with some sub-acute changes in the brain stem and medulla, an incipient pneumonia, and a high blood alcohol concentration (2.4 o/oo). The association of these findings suggest the role of a multi-factorial respiratory dysfunction as a pathophysiological mechanism leading to death. In fatal cases related to giant intracranial aneurysm, a number of triggers and contributing factors, with potential medico-legal implications, must be appropriately considered in the chain of events leading to death.
authors.affiliation: Hjelt-Institute, Department of Forensic Medicine, University of Helsinki, Helsinki, Finland. katarina.vaahtera@helsinki.fi
authors.forename: Katarina
authors.initials: K
authors.lastname: Vaahtera
authors.forename: Philippe
authors.initials: P
authors.lastname: Lunetta
mesh_terms: D000293:Adolescent; D001344:Autopsy; D020526:Brain Stem Infarctions; D002533:Cerebral Angiography; D003645:Death, Sudden / Q000209:etiology / Q000473:pathology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology*; D008297:Male