title: Papilledema as a Diagnostic Sign of Cerebral Edema on Postmortem Magnetic Resonance Imaging.
abstract: The purpose of this study was to investigate papilledema (PA) as a diagnostic criterion for the presence of antemortem or agonal cerebral edema despite normal postmortem brain swelling on postmortem magnetic resonance imaging (PMMR) in comparison with conventional autopsy.One hundred subjects with head PMMR and autopsy were included in this study. The sensitivities, spec icities, positive predictive values (PPVs), negative predictive values (NPVs), and accuracies were calculated in terms of the PA, PMMR, and cerebral edema on autopsy. Spearman r tests were used to analyze the linear correlations of PA and the radiological and autoptic determination of cerebral edema.In autopsy, the sensitivity regarding the presence of PA and cerebral edema was 66.2% (PPV, 70.5%), and specificity was 48.6% (NPV, 28.3%), with an overall accuracy of 60%. On PMMR, the sensitivity was 86.6% (PPV, 95%). The specificity was 90.9% (NPV, 34%), with an overall accuracy of 88%. The Spearman correlation revealed a statistically significant result (P < 0.001), which indicated a strong linear correlation of the presence of PA and cerebral edema with the autopsy results and the PMMR results.The presence of PA may aid in the diagnoses of cerebral edema despite normal postmortem brain swelling based on PMMR.
authors: From the *Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland; †Department of Anesthesiology, University Hospital Salzburg, Salzburg, Austria; and ‡Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland.
authors: Ralph
authors: R
authors: Neumann
authors: Janine
authors: J
authors: Abu-Isa
authors: Stamatios
authors: S
authors: Stamou
authors: Dominic
authors: D
authors: Gascho
authors: Michael J
authors: MJ
authors: Thali
authors: Lars C
authors: LC
authors: Ebert
authors: Patricia Mildred
authors: PM
authors: Flach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000175:diagnosis*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000473:pathology*; D011180:Postmortem Changes; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult