Quantitative analysis of brain edema and swelling on early postmortem computed tomography: comparison with antemortem computed tomography.
OBJECTIVE
The aim of this study was quantitatively to analyze brain edema and swelling due to early postmortem changes using computed tomography (CT) scans of the head.


METHODS
Review board approval was obtained, and informed consent was waived. A total of 41 patients who underwent head CT before and shortly after death were enrolled. Hounsfield units (HUs) of gray matter (GM) and white matter (WM) were measured at the levels of the basal ganglia, centrum semiovale, and high convexity area on both antemortem and postmortem CT. The length of the minor axis of the third ventricle at the level of the basal ganglia and the width of the central sulcus at the level of high convexity were measured.


RESULTS
At each level tested, the HUs of GM and the GM/WM ratios on postmortem CT were significantly lower than those on antemortem CT (P < 0.001). HUs of WM on postmortem CT were slightly higher than those on antemortem CT but without significant difference (P > 0.1). Postmortem CT showed subtle loss of distinction between GM and WM. The size of the third ventricle and the width of the central sulcus did not vary before and after death (P > 0.1).


CONCLUSIONS
Early postmortem CT shows mild brain edema but does not show brain swelling.
Takahashi
Naoya
N
Department of Diagnostic Radiology, Niigata City General Hospital, Shumoku, Chuo-ku, Niigata, 950-1197, Japan. nandtr@hosp.niigata.niigata.jp
Satou
Chihiro
C
Higuchi
Takeshi
T
Shiotani
Motoi
M
Maeda
Haruo
H
Hirose
Yasuo
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging*; D001929:Brain Edema / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D014057:Tomography, X-Ray Computed