Postmortem ophthalmologic examination by endoscopy

Abnormal intraocular findings detected during forensic autopsies have generally been ignored. In this study, we assessed the usefulness of postmortem ophthalmologic examination in 46 cases using an endoscope system with a tip diameter of 0.9 mm. This procedure was performed using a portable system, and only 1 assistant was needed. Furthermore, the procedure required only about 5 minutes for both eyes. Abnormal intraocular findings were seen in 22 (47.8%) of 46 cases. Fundus hemorrhages were observed in 4, and papilledema was observed in 3 of 5 cases of death due to head trauma; besides, it was possible to estimate the interval between head trauma and death based on intraocular findings. Seven of 16 cases of death from asphyxia presented abnormal intraocular findings, including retinal splinter hemorrhages. Fundus hemorrhages were observed in 2 of 3 cases of death by drowning, which, to our knowledge, had never been reported to date.Thus, this procedure proved easy to perform, and it may be useful to detect significant abnormal intraocular findings related to the presumed cause of death during autopsies.     

Anomalous origin of the right coronary artery from the left sinus of Valsalva: report of two cases.

Anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva (LSV) is rare and has only recently been recognized as a cause of sudden cardiac death in otherwise healthy individuals. In this report, we describe two cases of anomalous origin of the RCA from the LSV. In the first case, a previously healthy 11-year-old girl died suddenly and unexpectedly. An autopsy revealed no abnormalities, except for anomalous origin of the RCA from the LSV. In the second case, a 21-year-old woman died by drowning in a bath, probably after an episode of syncope brought about by anomalous origin of the RCA from the LSV.     

Sudden death due to undiagnosed intracranial hemangiopericytoma

A previously healthy 9-year-old Japanese boy with a 4-day history of vomiting and headache died suddenly and unexpectedly. An external examination revealed no abnormalities other than foam around the mouth and nose. An internal examination revealed severe pulmonary edema and hemorrhagic hemangiopericytoma arising from the choroid plexus of the right lateral ventricle. The cause of death was thought to be neurogenic pulmonary edema caused by the rapid growth of a hemangiopericytoma, with intratumoral hemorrhage.