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Contribution of Antemortem Computed Tomography Findings to Cause of Death Determination: An Unusual Fatal Stroke
Author(s) -
Rérolle Camille,
Pucheux Julien,
Lefrancq Thierry,
Barrault Céline,
SaintMartin Pauline
Publication year - 2015
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.12760
Subject(s) - medicine , abrasion (mechanical) , autopsy , radiology , computed tomography , pseudoaneurysm , carotid cavernous fistula , stroke (engine) , surgery , fistula , aneurysm , mechanical engineering , engineering
In the case reported here, the antemortem computed tomography scan ( CT scan) was essential in the forensic investigation. A 32‐year‐old man was found fully awake with a facial abrasion, after what seemed to be a car accident. He lost consciousness suddenly one hour after initial management. Successive CT scan showed a facial fracture and a metallic foreign body in the carotid canal associated with an occlusion/dissection of the left internal carotid, a pseudoaneurysm, and a carotid‐cavernous fistula. The victim died from a stroke. Autopsy confirmed that the facial abrasion was a gunshot entrance wound, the metallic foreign body being a projectile. Intracranial vascular injuries linked with gunshot wounds are most of the time isolated and due to pelet embolism. The observed vascular injury association has never been described in the existing literature. The CT scan provided a better understanding of the chronology of events that led to death.