Retropharyngeal Hematoma Secondary to Cervical Spine Surgery: Report of One Fatal Case

A 53‐year‐old woman suffering from radicular pain due to cervical herniation underwent a spinal surgery consisting of anterior cervical discectomy and fusion with an implantable titanium cage. Five hours after the procedure, the patient developed cervical swelling and dyspnea. An emergency surgery permitted evacuation of a deep cervical hematoma and intubation of the patient, who died some minutes later. The family of the deceased lodged a complaint with the public prosecutor because of unclear circumstances of death. After analysis of the medical records by two forensic pathologists, a medicolegal autopsy was ordered. Massive retropharyngeal and mediastinal hematomas were diagnosed. Pathological study confirmed acute cervical hemorrhage, but failed to detect the source of bleeding. The forensic pathologists concluded that death was due to mechanical asphyxia secondary to pharyngeal compression by the cervical hematoma. To the best of our knowledge, death secondary to retropharyngeal hematoma in this neurosurgical context is rarely encountered.     

Clinical effects and lethal and forensic aspects of propofol

Propofol is a potent intravenous anesthetic agent that rapidly induces sedation and unconsciousness. The potential for propofol dependency, recreational use, and abuse has only recently been recognized, and several cases of accidental overdose and suicide have emerged. In addition, the first documented case of murder using propofol was reported a few months ago, and a high profile case of suspected homicide with propofol is currently under investigation. A number of analytical methods have been employed to detect and quantify propofol concentrations in biological specimens. The reported propofol-related deaths and postmortem blood and tissue levels are reviewed. Importantly, limitations of propofol detection are discussed, and future considerations are presented. Because propofol has the potential for diversion with lethal consequences, the forensic scientist must have a basic understanding of its clinical indications and uses, pharmacologic properties, and detection methods. In addition, medical institutions should develop systems to prevent and detect diversion of this potential drug of abuse.     

Suicide by cop among female subjects in officer-involved shooting cases

An analysis of suicide by cop (SBC) among female subjects in a large sample (n = 707) of officer-involved shootings (OIS) is reported. Women represented 3% of the total sample (n = 21) and 5% (n = 12) of the 256 SBC cases. Therefore, 57% of the women (n = 12) were classified as SBC, and 81% of the women (n = 17) behaviorally evidenced some suicidal motivation. The results underscore that when a female subject becomes involved in a situation leading to an OIS, there is a very high likelihood that she is motivated to be intentionally killed. She is almost guaranteed to have a diagnosed mental disorder, has been prescribed psychiatric medications, and is abusing a substance at the time, most likely alcohol. Nevertheless, she also poses a serious risk of injury to both police officers and civilians during the encounter and will possess a firearm half the time. The wish for suicide is often precipitated by serious relationship issues. Comparisons are made to the male subjects in our previous study.     

还元注射液对出血性脑卒中PAG影响的临床与实验观察

目的：观察还元注射液对大鼠实验性脑出血和急性脑出血患者血液中血小板聚集率（ＰＡＧ）的影响。方法：利用脑立体定位、微量注射身体血法复制大鼠脑出血模型。同时，随机选６０例急性脑出血病例，观察还元注射液治疗后血中ＰＡＧ的变化。结果：脑出血模型动物、急性脑出血患者血中ＰＡＧ明显上升，还元注射液可在一定程度上抑制这种改变。结论：还元液射液对脑出血外周血中ＰＡＧ水平影响可能是其治疗出血性脑卒中的机制之一。     

寒邪致高血压大鼠脑出血的凝血-纤溶机制

目的 研究气温骤降所形成的寒邪导致高血压大鼠发生脑卒中的凝血-纤溶机制.方法 采用易卒中型肾血管性高血压(stroke prone renovascular hypertension,RHRSP)模型,放置于人工模拟的气温骤降环境中诱发脑卒中,检测气温骤降前后大鼠凝血-纤溶标记物F1+2和D-dimer的变化.结果 气...     

醒脑静治疗急性丘脑出血52例临床观察

［摘要］目的 观察醒脑静治疗急性丘脑出血的临床疗效。方法 将103例急性丘脑出血患者随机分为治疗组和对照组，两者均按CT分为3型，治疗组在对照组常规治疗基础上加用醒脑静治疗，观察两组各型丘脑出血治疗前后临床神经功能缺损程度评分变化，意识障碍转清及体温恢复情况。结果 与治疗前相比，治疗后两组Ⅰ型和Ⅱ型患者临床神经功能缺损程度评分比较显著降低（P<0.01），治疗组Ⅰ型、Ⅱ型患者评分显著低于对照组（Ⅰ型、Ⅱ型）,差异有统计学意义（P<0.05）。与对照组相比,治疗组意识障碍患者神志转清时间明显缩短（P<0.05）,发热患者平均体温升高幅度降低，体温恢复正常时间明显缩短（P<0.05）。结论 醒脑静对急性丘脑出血患者出现的意识障碍、发热及神经功能缺损等有明显治疗效果，能提高急性丘脑出血患者治愈率，降低致残率。