1/3. Traumatic subarachnoid hemorrhage and extracranial vertebral artery injury: a case report and review of the literature.The case is presented of a 19-year-old man who was assaulted and died shortly afterward from a large traumatic basal subarachnoid hemorrhage (TBSAH) that arose from rupture of the left vertebral artery, proximal to the point at which the artery penetrated the dura. The literature regarding TBSAH and vertebral artery rupture is reviewed, and a number of points are highlighted: patients with TBSAH may remain conscious for a period of hours after injury, subcutaneous or muscular bruising may be contralateral to the ruptured vessel, fractures of the transverse processes of the cervical vertebrae and significant pathology of the vertebral artery are not typically associated with TBSAH, and rupture of the vertebral artery may be intracranial, junctional, or extracranial.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. Medicolegal diagnostic value and clinical significance of traumatic incomplete tears of the basilar artery.Ruptures of arteries of the vertebrobasilary system are relatively frequent in medicolegal practice, and their origin may be both natural and violent. tears that affects the whole thickness of the basilar artery cause subarachnoid hemorrhage (SAH), with an often rapid fatal outcome. 1-3 However, in some situations, arterial tears may be incomplete, involving the intima or both the intima and the media, but with preserved adventitia. 1, 4 Although such incomplete tears are not the source of immediate subarachnoid bleeding, their presence may be important from both a medicolegal and a clinical point of view.The aim of this article is to point out the significance of incomplete tears of basilar artery as a possible diagnostic sign of traumatic origin of SAH as well as a certain mechanism of injury, which involves forcible hyperextension and rotational movements of the head. The authors also describe their method of performing longitudinal section of the basilar artery, both at autopsy and for histologic examination, which is convenient for identifying multiple transversal incomplete tears of this blood vessel. The article is based on the analysis of three cases from the autopsy material of the Institute of forensic medicine in Belgrade.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/3. Hyperextension and rotation of head causing internal carotid artery laceration with basilar subarachnoid hematoma.Hyperextension of the head can cause injury to the vessels at the base of the brain. These lacerations are believed to be caused by stretching of the vessels due to the abrupt movement of the head and rotational acceleration of the brain within the cranium, and they usually occur in the intracranial portions of the vessels, producing a subarachnoid hemorrhage. This is the case of a 35-year-old man who received a blow to the face that forcefully hyperextended and rotated his head to the left. autopsy revealed an intracranial right internal carotid laceration extending from a calcified atherosclerotic plaque. This unusual injury may be due to a combination of blunt force applied to the head and the alteration of the vessel's structural and functional capacities secondary to atherosclerosis.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |