title: The role of post-mortem imaging in a case of sudden death due to ascending aorta aneurysm rupture.
abstract: A 65-year-old man collapsed suddenly, while on an escalator. Despite intensive cardio-pulmonary resuscitation, the subject died 1h later. Post-mortem magnetic resonance imaging and post-mortem computed tomography angiography demonstrated rupture of an ascending aortic aneurysm, with haemorrhage into the pericardial cavity and the uncommon associated finding of haemorrhage into the left hemi-thorax through a small left-sided pericardial defect. The cause of death was thus attributed to the rupture of thoracic aortic aneurysm, and traditional autopsy was not performed. The circumstances of the case will be discussed, followed by a discussion of the imaging findings, mechanism of death, and explanation of the findings in this case. Finally, on the basis of this case report, we suggest that in selected cases, post-mortem imaging can be used as a screening tool for conducting hypotheses on the cause and mechanism of death before autopsy.
authors.affiliation: Institute of Forensic Medicine, Center of Forensic imaging and Virtopsy, University of Bern, Bühlstrasse 20, 3012 Bern, Switzerland. laura.filograna@rm.unicatt.it
authors.forename: Laura
authors.initials: L
authors.lastname: Filograna
authors.forename: Gary
authors.initials: G
authors.lastname: Hatch
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruder
authors.forename: Steffen G
authors.initials: SG
authors.lastname: Ross
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Bolliger
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000473:pathology*; D000792:Angiography / Q000379:methods*; D001013:Aorta, Thoracic / Q000473:pathology; D001014:Aortic Aneurysm / Q000473:pathology*; D003645:Death, Sudden / Q000209:etiology*; D049429:Forensic Pathology / Q000379:methods; D006470:Hemorrhage / Q000473:pathology; D006491:Hemothorax / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010490:Pericardial Effusion / Q000473:pathology; D014057:Tomography, X-Ray Computed