| Fatal Subarachnoid Hemorrhage Due to Ruptured Vertebrobasilar Aneurysm Associated With Giant Cell Arteritis in a Child. | |
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MedLine Citation:
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PMID: 20177371 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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A 3 1/2-year-old previously healthy female experienced an episode of sudden unresponsiveness witnessed by her mother. Upon arrival to the local hospital, imaging studies of the still unresponsive child revealed severe bilateral "flash" pulmonary edema and diffuse anoxic brain injury. Aggressive resuscitative efforts were unsuccessful, and she was pronounced dead. External examination at autopsy was essentially unremarkable. Internal examination of the head revealed diffuse basilar subarachnoid blood originating from a collapsed, 2 cm irregular aneurysm arising from the junction of the vertebral and basilar arteries. Additionally, multiple calcified subpleural, parenchymal, and hilar nodal pulmonary granulomas were identified. The remaining internal examination, including that of the aorta and its major branches, was unremarkable. Histologic examination of the aneurysm revealed alternating mural attenuation and thickening, the latter resulting from prominent intimal proliferation with active fibroplasia. Most notably, numerous isolated and clustered multinucleated giant cells were seen, most prominently in areas of more intense inflammation. Specific immunolabeling and silver staining of the pulmonary granulomas revealed evidence of histoplasmosis, but both were negative for fungal elements in the aneurysm, as was ultrastructural examination. The cause of death is fatal subarachnoid hemorrhage due to rupture of a vertebrobasilar artery aneurysm caused by isolated intracranial giant cell arteritis. |
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Authors:
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Robert F Corliss; Sara Zydowicz; M Shahriar Salamat |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-2-19 |
Journal Detail:
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Title: The American journal of forensic medicine and pathology : official publication of the National Association of Medical Examiners Volume: - ISSN: 1533-404X ISO Abbreviation: - Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-2-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8108948 Medline TA: Am J Forensic Med Pathol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisc. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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