Bilateral middle cerebral artery infarction associated with traumatic common carotid artery dissection: a case report and review of literature.
Traumatic common carotid artery dissection is very rare, and although it is associated with mild symptoms, it can sometimes be fatal. Therefore, careful examination of common carotid artery dissection and additional pathological examination as appropriate are important during the autopsy of traumatic death patients. A 60-year-old previously healthy drunken woman was run over. She had remained unconscious shortly after the accident, and 15 h later, emerging bilateral cerebral infarction was confirmed using brain computed tomography. Despite conservative management, she died 4 days after the injury due to multiple chest traumas and broad cerebral infarction. A medico-legal autopsy was conducted. According to the autopsy results, microscopically identified common carotid artery dissections with thrombus formation were considered the cause of infarction. In the present case, macroscopic common carotid artery lesions were relatively mild, and this made diagnosis difficult. However, the correct diagnosis was achieved by a combined analysis of the antemortem images and autopsy results. Thus, in such cases, a combined comprehensive analysis of autopsy results and antemortem clinical images is important to determine the exact cause of death.
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan. Electronic address: chibafumico@chiba-u.jp.
Fumiko
F
Chiba
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan; Department of Radiology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Yohsuke
Y
Makino
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Ayumi
A
Motomura
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Go
G
Inokuchi
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Namiko
N
Ishii
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Suguru
S
Torimitsu
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Ayaka
A
Sakuma
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Sayaka
S
Nagasawa
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Hisako
H
Saito
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Daisuke
D
Yajima
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Mutsumi
M
Hayakawa
Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba Prefecture 260-8670, Japan.
Hirotaro
H
Iwase
D000063:Accidents, Traffic; D000435:Alcoholic Intoxication / Q000150:complications; D020212:Carotid Artery Injuries / Q000473:pathology*; D002341:Carotid Artery Thrombosis / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
Antemortem images; Cerebral infarction; Forensic pathology; Middle cerebral artery; Traumatic common carotid artery dissection