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1.
Leg Med (Tokyo) ; 66: 102377, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38154350

RESUMO

We present the case of a 69 years old man who was hit by a car while crossing the road. A CT scan of the skull and brain showed fracture of the left occipital bone, bilateral hemispheric subarachnoid hemorrhage, right frontal-temporal-parietal subdural hematoma with a shift of midline structures of 18 mm and complete obliteration of the third ventricle. He showed signs of anisocoria, absence of mobility of all 4 limbs and was immediately intubated and admitted to intensive care. The neurosurgeon was immediately consulted. He underwent drainage of subdural hematoma and two decompressive craniotomies, but died 15 days after the initial trauma. At autopsy, the stomach was full of a greenish poltaceous material. This gave us vital information in reconducting the actual brain death of the man to the immediacy of the investment, helping in the process of ruling out any possible profiles of professional liability.


Assuntos
Fraturas Ósseas , Hemorragia Subaracnóidea , Masculino , Humanos , Idoso , Hematoma Subdural/diagnóstico por imagem , Hematoma Subdural/cirurgia , Encéfalo , Tomografia Computadorizada por Raios X
2.
Leg Med (Tokyo) ; 67: 102386, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38157675

RESUMO

We present the case of a 61 years old woman who was hit by a car, resulting in fractures of the pubic bone, left ischium-pubis ramus and right femur, with need of hip replacement surgery. In the next days she was affected by two episodes of acute coronary syndrome, treated with coronary angioplasty surgery. After undergoing total hip replacement surgery an episode of asystole caused her death. A full autopsy showed coronary stenosis and chronic ischemic heart disease associated with a recent myocardial infarction. The pre-existing condition of T.L. could not be ignored but the initial traumatic event and the subsequent fractures played a further co-occurrent causal role. The initial trauma represented the first step of the phenomenological chain that led to a series of adverse cardiological events and to an irreversible asystole, so that the car driver should be partly considered accountable for the death of the woman.


Assuntos
Parada Cardíaca , Isquemia Miocárdica , Humanos , Feminino , Pessoa de Meia-Idade , Homicídio , Autopsia
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