Bilateral middle cerebral artery infarction associated with traumatic common carotid artery dissection: a case report and review of literature

Forensic Sci Int. 2014 Mar:236:e1-4. doi: 10.1016/j.forsciint.2014.01.003. Epub 2014 Jan 10.

Abstract

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.

Keywords: Antemortem images; Cerebral infarction; Forensic pathology; Middle cerebral artery; Traumatic common carotid artery dissection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Alcoholic Intoxication / complications
  • Carotid Artery Injuries / pathology*
  • Carotid Artery Thrombosis / pathology
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / pathology*
  • Female
  • Forensic Pathology
  • Humans
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / pathology*
  • Middle Aged
  • Tomography, X-Ray Computed
  • Tunica Intima / pathology
  • Tunica Media / pathology