title: Acute brainstem compression by intratumoral hemorrhages in an intracranial hypoglossal schwannoma.
abstract: A 77-year-old female in the hospital was found tachycardic and hypothermic by a nurse, and the patient's respiration subsequently ceased. Forensic autopsy revealed an intracranial cystic tumor that would have compressed the brainstem. On microscopic examination, the tumor was diagnosed as an Antoni A schwannoma growth, and recent multiple intratumoral hemorrhages in the intracranial schwannoma were observed, suggesting the sudden enlargement of the intracranial schwannoma due to intratumoral hemorrhaging. Accordingly, we diagnosed the cause of death as brainstem compression induced by the intratumoral hemorrhaging in the intracranial schwannoma. Meanwhile, a rhinopharyngeal tumor was also detected by the autopsy, which was compatible with an antemortem diagnosis of a dumbbell-shaped hypoglossal schwannoma.
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan. inoueh@doc.medic.mie-u.ac.jp
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Inoue
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ikemura
authors.forename: Eri
authors.initials: E
authors.lastname: Usugi
authors.forename: Yuma
authors.initials: Y
authors.lastname: Kiyofuji
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nata
mesh_terms: D000368:Aged; D001344:Autopsy; D001933:Brain Stem / Q000473:pathology*; D016887:Cardiopulmonary Resuscitation; D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D003680:Deglutition Disorders / Q000150:complications / Q000209:etiology; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence; D017809:Fatal Outcome; D005260:Female; D049429:Forensic Pathology / Q000331:legislation & jurisprudence / Q000379:methods; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D020437:Hypoglossal Nerve Diseases / Q000150:complications / Q000473:pathology*; D007035:Hypothermia / Q000175:diagnosis / Q000209:etiology; D000860:Hypoxia / Q000150:complications / Q000209:etiology; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000175:diagnosis; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence*; D009442:Neurilemmoma / Q000150:complications / Q000473:pathology*; D018458:Persistent Vegetative State / Q000150:complications / Q000209:etiology; D013610:Tachycardia / Q000175:diagnosis / Q000209:etiology
keywords: Brainstem compression; Dumbbell-shaped schwannoma; Hypothermia; Intratumoral hemorrhage; Respiratory disturbance; Tachycardia