Hemorrhagic Retinopathy and Optic Nerve Sheath Hemorrhage Associated With Fatal Subarachnoid Hemorrhage from a Ruptured Intracranial Aneurysm Due to Segmental Fibromuscular Dysplasia |
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Authors: | Elizabeth O. Silloca-Cabana M.D. Vivian M. Hathuc D.O. William T. Harrison M.D. Patrick E. Lantz M.D. |
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Affiliation: | 1. Department of Pathology, Wake Forest Baptist Health, Medical Center Blvd., Winston Salem, NC, 27157;2. Department of Pathology, Ascension Genesys Hospital, 1 Genesys Pkwy, Grand Blanc, MI, 48439 |
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Abstract: | Fibromuscular dysplasia is an idiopathic, nonatheromatous, and noninflammatory arterial disease that most commonly affects the renal and carotid arteries. We report a child with subarachnoid and ocular hemorrhage associated with an aneurysm due to fibromuscular dysplasia. Computed tomography following a witnessed collapse revealed diffuse subarachnoid hemorrhage and severe cerebral edema. An autopsy confirmed the radiographic findings and detected bilateral retinal hemorrhages, optic nerve sheath hemorrhages, and a ruptured saccular aneurysm due to focal fibromuscular dysplasia involving the intracranial right vertebral artery. This case documents a fatal subarachnoid hemorrhage in a child with an intracranial saccular aneurysm caused by fibromuscular dysplasia. The associated retinal hemorrhages are easily detected by postmortem monocular indirect ophthalmoscopy. |
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Keywords: | forensic science fibromuscular dysplasia cerebral aneurysm subarachnoid hemorrhage retinal hemorrhage optic nerve sheath hemorrhage postmortem monocular indirect ophthalmoscopy autopsy |
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