title: Observation of vertebral artery damage using angioscopy in autopsy cases.
abstract: The vertebral arteries are important blood vessels that supply the cerebral circulation in conjunction with the internal carotid arteries. In cases of subarachnoid hemorrhage, it is necessary to examine the vertebral arteries as potential sources of bleeding due to blunt trauma (head and neck) or of cerebral embolism that originated on the surface of the damaged intima as a result of hyperflexion or hyperextension. However, a considerable part of the vertebral arterial surface is surrounded by bone, resulting in challenges during examination in a routine autopsy. In this study, angioscopy was used to inspect the vertebral artery intima for damage in cases of neck injury, head injury, or neck strangulation. Intimal damage was detected in 34 out of the total 75 cases. Of the 28 cases with cervical discopathy or fracture, 61% had intimal damage. In addition, postmortem application of computed tomography angiography was performed to identify the injured vessel in a case with traumatic subarachnoid hemorrhage, and a perforated hole was detected using angioscopy, which did not introduce autopsy-related artifacts. Therefore, angioscopy may be a useful and nondestructive method to identify intimal damage in the vertebral arteries during an autopsy.
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo, Chiba City, Chiba, 260-8670, Japan, aama0171@chiba-u.jp.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Motomura
authors.forename: Go
authors.initials: G
authors.lastname: Inokuchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yajima
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Makino
authors.forename: Fumiko
authors.initials: F
authors.lastname: Chiba
authors.forename: Suguru
authors.initials: S
authors.lastname: Torimitsu
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sato
authors.forename: Katsura
authors.initials: K
authors.lastname: Otsuka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Odo
authors.forename: Hirotaro
authors.initials: H
authors.lastname: Iwase
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017546:Angioscopy; D001237:Asphyxia / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology; D004332:Drowning / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D019838:Neck Injuries / Q000473:pathology; D012769:Shock / Q000473:pathology; D017539:Tunica Intima / Q000293:injuries / Q000473:pathology; D014711:Vertebral Artery / Q000293:injuries* / Q000473:pathology*; D055815:Young Adult