The source of haemorrhage in traumatic basal subarachnoid haemorrhage

Wong, Brittany, Ong, Beng Beng and Milne, Nathan (2015) The source of haemorrhage in traumatic basal subarachnoid haemorrhage. Journal of Forensic and Legal Medicine, 29 18-23. doi:10.1016/j.jflm.2014.09.012

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Author Wong, Brittany
Ong, Beng Beng
Milne, Nathan
Title The source of haemorrhage in traumatic basal subarachnoid haemorrhage
Journal name Journal of Forensic and Legal Medicine   Check publisher's open access policy
ISSN 1752-928X
1532-2009
Publication date 2015-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.jflm.2014.09.012
Open Access Status
Volume 29
Start page 18
End page 23
Total pages 6
Place of publication Kidlington United Kingdom
Publisher Churchill Livingstone
Collection year 2015
Language eng
Abstract Traumatic basal subarachnoid haemorrhage (TBSH) following trauma to the head, face or neck is well-established as a cause of death; however it remains a heavily disputed topic as the site of vascular injury is difficult to identify. Whilst many regions within the vasculature of the head and neck have been proposed as more susceptible to rupture, the vertebral artery remains the focal point of many investigations. We present a retrospective case review of TBSH in our forensic centre at Forensic and Scientific Services in Brisbane, Australia, from 2003 to 2011. Thirteen cases of TBSH were found, one case excluded due to vasculopathy. All decedents were male, the majority of which were involved in an altercation receiving blows to the head, face, or neck and were unconscious at the scene. All victims were under the influence of alcohol, drugs, or a combination thereof. External examination revealed injuries to the head, face, and neck in all cases. Various combinations of further examination techniques were used during the post-mortem examination including brain and/or cervical spine retention, CT imaging, and angiography. Vascular injury was identified in eight of the twelve cases, all of which occurred intracranially, with seven involving the vertebral artery. Histology was most reliable in identifying the rupture site and angiography failed to reveal a rupture site. The added benefits of histology over angiography are the ability to identify the microscopic architecture of the tear and to diagnose vasculopathy that may have rendered the individual more susceptible to TBSH.
Keyword Subarachnoid haemorrhage
Trauma
Vertebral artery
Post-mortem examination
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 1 Nov 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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