Pulmonary embolisation of bone fragments from penetrating cranial gunshot wounds

Cecchi, Rossana; Cipolloni, Luigi; Sestili, Cristina; Aromatario, Mariarosaria; Ciallella, Costantino

doi:10.1007/s00414-011-0643-9

Cited by 12 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In all the articles reviewed [ 124 , 125 , 131 , 132 , 133 , 134 , 135 , 136 ], the presence of blood between dural layers was confirmed by imaging and by surgical and microscopic examinations. Blood was always located in the fronto-temporal convexity region, more often on the right side (78%).…”

Section: Interdural Hematomamentioning

confidence: 99%

“…In most cases there was no history of trauma, except for one in which the hematoma developed under a bone fracture [ 133 , 134 ]. Thus, in the majority of cases examined, the source of bleeding was not identified, not even with a CT angiography [ 135 ].…”

Section: Interdural Hematomamentioning

confidence: 99%

“…Macroscopical and histological examination showed common findings in the hematomas such as blood clots in various stages of organization [ 124 , 125 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 ]. In one case, an immunohistochemical test was performed, confirming the absence of neoplastic cells [ 133 , 134 ]. In 2017, Genc et al reported a curious case of chronic interdural hematoma that showed calcification and osseous metaplasia with bone and fatty tissue [ 136 ].…”

Section: Interdural Hematomamentioning

confidence: 99%

See 2 more Smart Citations

Traumatic Epidural and Subdural Hematoma: Epidemiology, Outcome, and Dating

et al. 2021

View full text Add to dashboard Cite

Epidural hematomas (EDHs) and subdural hematomas (SDHs), or so-called extra-axial bleedings, are common clinical entities after a traumatic brain injury (TBI). A forensic pathologist often analyzes cases of traumatic EDHs or SDHs due to road accidents, suicides, homicides, assaults, domestic or on-the-job accidents, and even in a medical responsibility scenario. The aim of this review is to give an overview of the published data in the medical literature, useful to forensic pathologists. We mainly focused on the data from the last 15 years, and considered the most updated protocols and diagnostic-therapeutic tools. This study reviews the epidemiology, outcome, and dating of extra-axial hematomas in the adult population; studies on the controversial interdural hematoma are also included.

show abstract

Section: Interdural Hematomamentioning

confidence: 99%

Section: Interdural Hematomamentioning

confidence: 99%

Section: Interdural Hematomamentioning

confidence: 99%

See 1 more Smart Citation

Traumatic Epidural and Subdural Hematoma: Epidemiology, Outcome, and Dating

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Non-thrombotic substrate with pulmonary embolic potential includes septic bacterial [2] or fungal vegetations, parasitic echinococcal cysts [3] or schistosomal ova, atherosclerotic cholesterol-rich debris, or a variety of foreign material such as bullets and shotgun pellets, central venous access catheter, silicon, hyaluronic acid dermal filler [4], cotton fibers, talc, microcrystalline cellulose [5], and other insoluble compounds of oral medications that are injected intravenously [6]. A further type of non-thrombotic pulmonary embolism that should be taken into consideration is trauma-related or iatrogenic tissue pulmonary embolism of bone [7] or cartilage fragments, gross fatty particles [8], skin, crushed hepatic tissue, or brain fragments. Furthermore, a variety of cells can spontaneously enter and obstruct pulmonary circulation.…”

Section: Discussionmentioning

confidence: 98%

Renal cell carcinoma pulmonary embolism: a rare cause of sudden death

Janík

Hejna

2015

Forensic Sci Med Pathol

View full text Add to dashboard Cite

An otherwise healthy 46-year-old man developed sudden-onset dyspnea, became unresponsive, and despite resuscitative measures, failed to recover. A review of his medical history was unremarkable except for a 4-month history of intermittent fever, malaise, and sporadic episodes of headache.Autopsy revealed the body of an adequately nourished Caucasian male, 181 cm in height and 79 kg in weight. External examination of the body revealed gynecomastia and a minor full-thickness forehead laceration. Major internal findings were confined to the right kidney and the lungs.Examination of the enlarged right kidney showed a whitish irregular tumor mass protruding from the cortical surface. The cut surface displayed an approximately 8 9 6.5 9 5 cm fleshy, gray-white, poorly circumscribed solid tumor mass with central necrosis that had extended above the cut surface and replaced almost the entire midportion of the renal parenchyma (Fig. 1). The tumor mass extended focally into the renal capsule, calyces, renal pelvis, and renal vein. In addition to the irregularly-shaped central tumor mass multiple smaller satellite nodules (up to 1 cm across), that were similar in appearance, were noted in the lower pole of the kidney, with evidence of direct renal vein and pelvis involvement. The right adrenal gland and perinephric fat were grossly uninvolved. The left kidney was unremarkable. No metastatic foci were detected in any regional lymph nodes or distant viscera. The lungs were moderately congested and edematous. There were no signs of lung infarctions or parenchymal tumor implants. The cut surface of both lungs showed grossly visible obstruction of the small pulmonary arteries by whitish homogeneous material. The gross appearance of the emboli was similar to the right kidney masses.Further dissection demonstrated an acutely dilated right cardiac chamber. The cardiovascular system was otherwise unremarkable. Postmortem toxicological assay was noncontributory.Histological examination of multiple samples from the renal masses (Fig. 2a) and the embolic material from the pulmonary arteries (Fig. 3a, b) revealed highly anaplastic spindle cell morphology with marked nuclear pleomorphism and increased mitotic activity reminiscent of sarcoma. Despite extensive sampling, no epithelial component was revealed histologically.Immunohistochemically, however, the spindle-shaped cells were strongly positive for renal cell carcinoma (RCC) markers (Figs. 2b, 3c), Vimentin (Figs. 2d, 3d), CD 10 (Figs. 2c, 3e), and CD 31. In addition, tumor cells were weakly reactive for epithelial membrane antigen (EMA). All morphological and immunotypical features were consistent with sarcomatoid RCC. The cause of death was determined to be pulmonary tumor embolism due to sarcomatoid RCC.

show abstract

“…In addition, a single case of skeletal muscle pulmonary embolisation has been described in the literature, which occurred after peritoneal dialysis in a 75-year-old woman [ 6 ]. As in that case, most of these embolic tissue fragments usually happen due to a severe musculoskeletal and/or soft tissue trauma [ 7 ]. After trauma, cells from the damaged tissue enter the bloodstream through ruptured vessels (veins and venules) in the injury or fracture site, and they may reach the lung circulation, where they become trapped within the pulmonary microvasculature [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary and Systemic Skeletal Muscle Embolism in a Beaked Whale with a Massive Trauma of Unknown Aetiology

Sierra

Ramírez

Quirós

et al. 2022

Animals

View full text Add to dashboard Cite

An adult female Sowerby’s beaked whale was found floating dead in Hermigua (La Gomera, Canary Islands, Spain) on 7 December 2016. Severe traumas of unknown aetiology were attributed, and the gross and microscopic findings are consistent with catastrophic trauma as a cause of death. Rib fractures affected the intercostals, transverse thoracis skeletal muscles, and thoracic rete mirabile. Degenerated muscle fibres were extruded to flow into vascular and lymphatic vessels travelling to several anatomic locations into the thoracic cavity, including the lungs, where they occluded the small lumen of pulmonary microvasculature. A pulmonary and systemic skeletal muscle embolism was diagnosed, constituting the first description of this kind of embolism in an animal. The only previous description has been reported in a woman after peritoneal dialysis. Skeletal pulmonary embolism should be considered a valuable diagnostic for different types of trauma in vivo in wild animals. This is especially valuable when working with decomposed carcasses, as in those cases, it is not always feasible to assess other traumatic evidence.

show abstract

Pulmonary embolisation of bone fragments from penetrating cranial gunshot wounds

Cited by 12 publications

References 21 publications

Traumatic Epidural and Subdural Hematoma: Epidemiology, Outcome, and Dating

Traumatic Epidural and Subdural Hematoma: Epidemiology, Outcome, and Dating

Renal cell carcinoma pulmonary embolism: a rare cause of sudden death

Pulmonary and Systemic Skeletal Muscle Embolism in a Beaked Whale with a Massive Trauma of Unknown Aetiology

Contact Info

Product

Resources

About