title: Fatal basilar thrombosis possibly related to minor cervical trauma: a case report.
abstract: Background. Basilar thrombosis is a potentially fatal event, whose traumatic etiology has been repeatedly stated. Methods. We performed the autopsy and the microscopic examination of the brain stem structures from an individual, whose sudden death raised logical suspicions regarding the causative factor. Results. The brain was swollen and clearly hyperemic; a massive basilar thrombus with complete occlusion of the median segment of the basilar artery was macroscopically seen. The brainstem showed an infarcted zone in the pons, with secondary hemorrhagic changes, mainly in the form of multiple petechial hemorrhages. Pontine arteries showed extensive alterations, mainly in the form of severed endothelium, which suggested a thrombotic-traumatic mechanism as the main etiological factor. Conclusions. Minor injuries, such as slight whiplashes, abrupt neck movements, neck trauma related to the slowing down of the vehicles, and critical neck positioning, can all of them explain a thrombotic event in the basilar artery, leading to a fatal occurrence. Other risk factors may obviously concur, but their importance seems unclear.
authors.affiliation: Institute of Legal Medicine, University Hospital Center "Mother Theresa", Rr. Dibres 371, 1005 Tirana, Albania.
authors.forename: Elmaz
authors.initials: E
authors.lastname: Shaqiri
authors.forename: Gentian
authors.initials: G
authors.lastname: Vyshka
authors.forename: Admir
authors.initials: A
authors.lastname: Sinamati
authors.forename: Besim
authors.initials: B
authors.lastname: Ymaj
authors.forename: Zija
authors.initials: Z
authors.lastname: Ismaili
references.citation: Brain. 1946 Jun;69(2):73-121
references.pmid: 20274363
references.citation: Resuscitation. 2003 Oct;59(1):147-54
references.pmid: 14580746
references.citation: Arch Neurol. 2002 Apr;59(4):567-73
references.pmid: 11939891
references.citation: Cerebrovasc Dis. 2006;21(1-2):140-1
references.pmid: 16374003
references.citation: Stroke. 2006 Mar;37(3):922-8
references.pmid: 16439705
references.citation: Forensic Sci Int. 1990 Apr;45(3):239-45
references.pmid: 2361646
references.citation: BMJ Case Rep. 2010;2010:
references.pmid: 22461857
references.citation: Emerg Med Clin North Am. 2004 Nov;22(4):1081-98
references.pmid: 15474783
references.citation: Stroke. 2006 Sep;37(9):2440
references.pmid: 16888267
references.citation: Can J Neurol Sci. 2003 Nov;30(4):320-5
references.pmid: 14672263
references.citation: Surg Neurol. 2006 Mar;65(3):238-45; discussion 245-6
references.pmid: 16488240
references.citation: JAMA. 1993 Apr 28;269(16):2085-6
references.pmid: 8468755
references.citation: J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1238-41
references.pmid: 16107358
references.citation: J Clin Pathol. 2002 Jan;55(1):44-50
references.pmid: 11825924
references.citation: J Neuroimaging. 1995 Jan;5(1):16-22
references.pmid: 7849367