Bleeding-Source Exploration in Subdural Hematoma: Observational Study on the Usefulness of Postmortem Computed Tomography Angiography
Kazuhisa Funayama,
Akihide Koyama,
Rieka Katsuragi-Go,
Takashi Aoyama,
Hiraku Watanabe,
Naoya Takahashi,
Hisakazu Takatsuka
Affiliations
Kazuhisa Funayama
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Akihide Koyama
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Rieka Katsuragi-Go
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Takashi Aoyama
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Hiraku Watanabe
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Naoya Takahashi
Center of Cause of Death Investigation, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Hisakazu Takatsuka
Division of Legal Medicine, Department of Community Preventive Medicine, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata 951-8510, Japan
In a few cases, postmortem computed tomography angiography (PMCTA) is effective in postmortem detection of cortical artery rupture causing subdural hematoma (SDH), which is difficult to detect at autopsy. Here, we explore the usefulness and limitations of PMCTA in detecting the sites of cortical arterial rupture for SDH. In 6 of 10 cases, extravascular leakage of contrast material at nine different places enabled PMCTA to identify cortical arterial rupture. PMCTA did not induce destructive arterial artifacts, which often occur during autopsy. We found that, although not in all cases, PMCTA could show the site of cortical arterial rupture causing subdural hematoma in some cases. This technique is beneficial for cases of SDH autopsy, as it can be performed nondestructively and before destructive artifacts from the autopsy occur.
