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41.
Missed Opportunities for Diagnosis of Post‐traumatic Thrombosis: A Case Series and Literature Review
Marzieh Hosseini M.D. Arya Hedjazi M.D. Mohammadreza Bahrani M.D. 《Journal of forensic sciences》2014,59(5):1417-1419
Thrombosis is caused by abnormalities in the composition of the blood, the quality of the vessel wall, and the nature of the blood flow. Herein, we present four cases of fatal thrombus formation after a trauma, which were missed at clinical diagnosis as the symptoms were misinterpreted. We stress that a blunt trauma can be fatal because of its direct and indirect kinetic energy effects at the subacute phase. This report highlights the importance of considering thrombosis in the diagnosis of closed trauma, which is usually missed because of lack of awareness for early diagnosis and treatment or is detected too late for any therapeutic intervention, which can result in avoidable morbidity and mortality. 相似文献
42.
颈动脉钝性损伤的发生率虽低,但死亡率高,易发生于交通事故、扼勒、缢吊、颈部直接外力作用和高坠等案例中。颈动脉钝性损伤有5种基础成伤机制:颈部直接外力作用,颈部过度伸展和旋转,颅底骨折碎片切割,口腔内扁桃体窝处直接外力作用,头胸部复合伤造成颈动脉被牵拉。国外相关研究文献和个案报道较多,而国内未见系统研究,不多的个案报道中,也有错误鉴定案例。本文对颈动脉钝性损伤的致伤方式、解剖学和生物学基础、成伤机制和法医学鉴定注意事项进行综述,希望能引起国内法医技术人员的重视,并为相关研究和应用提供参考。 相似文献
43.
Nerantzis CE Koulouris SN Marianou SK Pastromas SC Koutsaftis PN Agapitos EB 《Journal of forensic sciences》2011,56(3):645-648
Sudden unexpected death is frequent in street heroin addicts. We conducted a histologic study of the sinus node (SN) to offer some evidence about the possible arrhythmogenic cause of death. Postmortem coronary angiography and microscopic examination of the SN and the perinodal area were performed in 50 heroin addicts (group 1) and in 50 nonaddicts (group 2), all men (16-40 years old). In heroin addicts, fatty and/or fibrous tissue replaced SN tissue in 21 cases (42%). Perinodal infiltration was found in 15 cases (30%). Fibromuscular dysplasia in branches of the sinus node artery (SNA) was found in eight cases (16%). Inflammation with focal and/or diffuse concentration of round cells was detected in the SN in 22 cases (44%). Old mural thrombi were also found in 13 cases (26%). The histologic changes in the SN and perinodal area offer an explanation about the possible mechanism of arrhythmia and sudden death in this population. 相似文献
44.
Blunt chest trauma from rapid automobile airbag deployment causing coronary artery occlusion and myocardial infarction is a rare but potentially fatal condition. We present the case of a 37-year-old man who developed extensive anterior and inferior myocardial infarction because of occlusion of both left anterior and right coronary arteries following blunt injury to the chest in a car accident. The patient was scheduled for emergency coronary angiography but left and right coronary ostia were not cannulated because of thrombus formation probably. The patient died, and the autopsy revealed external compression by epicardial hematomas involving separately left and right coronary arteries and the coronary sinus without signs of coronary and/or aortic dissection. To our knowledge, this is the first case presenting occlusion of both coronary arteries secondary to blunt chest trauma causing acute myocardial infarction in a young man without signs of prior coronary artery disease. 相似文献
45.
Saddle Pulmonary Embolism with Paradoxical Coronary Artery Embolism through a Patent Foramen Ovale
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Amber L. Achesinski M.P.A. Wendy M. Gunther M.D. Catherine B. Pearman M.P.A.S. 《Journal of forensic sciences》2017,62(3):812-814
A 35‐year‐old male patient was found in cardiac arrest in his vehicle, with no apparent injuries after a minor motor vehicle collision. The decedent was found to have a saddle pulmonary embolus with a thromboembolus impacted across a patent foramen ovale and a paradoxical embolism in the circumflex coronary artery, as well as significant clotting in the deep veins of both lower extremities. There were no risk factors in his history to explain the deep venous thrombosis; family history suggested the possibility of an unrecognized clotting disorder. 相似文献
46.
John Gilbert F.R.C.P.A. Mary N. Sheppard M.D. Roger W. Byard M.D. 《Journal of forensic sciences》2017,62(2):531-535
Two cases of occult pseudoaneurysms of the sinus of Valsalva (SoV) are reported to demonstrate different etiologies and lethal mechanisms. A previously well 9‐month‐old boy who suffered an unexpected fatal cardiorespiratory arrest was found at autopsy to have a ruptured pseudoaneurysm of the left SoV resulting in lethal hemopericardium. A 13.5‐month‐old boy died soon after presenting with a 24‐h history of poor feeding and reduced urine output. At autopsy, destruction of the noncoronary cusp of the aortic valve by bacterial endocarditis was found with extension of the inflammation into a pseudoaneurysm of the SoV with surrounding abscess formation involving the atrioventricular node. Death was most likely due to an arrhythmia. Pseudoaneurysms of the SoV are exceedingly rare but may result in sudden/unexpected death in infancy and early childhood from rupture or involvement of the conduction system or myocardium. Detailed cardiac examination is essential in all unexpected deaths in early life. 相似文献
47.
The Frontal Sinus Cavity Exhibits Sexual Dimorphism in 3D Cone‐beam CT Images and can be Used for Sex Determination
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Isabela G. G. Choi M.Sc. Eduardo F. Duailibi‐Neto Ph.D. Thiago L. Beaini Ph.D. Renan L. B. da Silva D.D.S Israel Chilvarquer Ph.D. 《Journal of forensic sciences》2018,63(3):692-698
Few studies have assessed the use of the frontal sinus cavities for sex differentiation. In this study, a new methodology was used to assess the reliability of CBCT images of the frontal sinus cavity for determining sex based on the sexual dimorphism found in this anatomical structure. The survey sample consisted of 130 scans that were reconstructed three‐dimensionally. 3D images of the cavity volume in the frontal, lateral, and basal views were exported in TIFF. The following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity, and Feret's diameter. The methodology demonstrated the existence of sexual dimorphism with an accuracy of 80.0% in the logistic regression model. The basal view had the greatest explanatory power in the final model. This methodology may be used as an alternative way of determining a reliable biological profile during the analysis of skeletal remains. 相似文献
48.
K S Saternus 《Forensic science international》1984,25(4):265-275
The vertebral artery was investigated in suicidal hanging for specific forensic, but also general traumatological reasons. The objective was to establish the extent to which the vertebral artery in its relatively protected position is injured at all and if so, in what form. For this purpose, cervical spine preparations with the posterior space of the skull were fixed in formalin and detached in the sagittal plane in 36 unselected cases of suicidal hanging after angiographic visualization of the vertebral artery. Afterwards, both vertebral arteries were visualized, and vascular injuries were compared with injuries of the soft tissues of the neck, of the cervical spine, and of the external types of hanging. The vertebral artery was shown to be injured quite frequently (rupture, intimal tear, sub-intimal hemorrhage), namely in one quarter of all cases, and indeed in more than half taking into account the perivascular bleeding. In this way, frequencies were found which were far in excess of those of the common carotid artery. The different mechanical behavior of these two paired neck arteries in traction are dealt with and the form of injury explained. 相似文献
49.
Akira Kurosu M.D. Ph.D. Kazumi Kuroyanagi M.D. Shinobu Yamauchi Ph.D. Kazunobu Omura Ph.D. Kazuyuki Saito M.D. Ph.D. 《Journal of forensic sciences》2016,61(2):548-550
Anomalous origin of the coronary artery (AOCA) is a rare, but important cause of sudden cardiac death among young athletes. Nine autopsy cases (8 male, 1 female; mean age, 17.9 years; age range, 11–31 years) of sudden death during or just after exercise caused by AOCA were reviewed. The exercises performed at the time of death were running (4 cases), soccer (2 cases), and baseball, swimming and kendo (Japanese swordsmanship) (1 case each). In 6 cases, the left coronary artery arose from the right sinus of Valsalva, and in 3, the right coronary artery from the left sinus. The coronary arteries passed between the pulmonary artery and the aorta with an acute angle takeoff from the orifice. Three cases had cardiovascular manifestations prior to death. In cases with cardiovascular manifestations, novel imaging methods should be considered to prevent sudden death. 相似文献
50.
D. Mayer A. Lukic V. Petrovecki M. Bakovic D. Strinovic J. Skavic 《Forensic Science International Supplement Series》2009,1(1):66-68