Utility of post mortem computed tomography in clivus fracture diagnosis. Case illustration and literature review

Role of post mortem computed tomography in diagnosis of upper cervical fractures in child due to road accident: A case report and literature review

“…This distinction is a potential pitfall in PMCT. 26,27 According to Kasahara et al 27 cervical cord injuries as such were not visualised on PMCT images in all cases; in his experience in six cases, cervical spinal bone fractures were detected as indirect findings of cervical cord injuries, and these cases were categorised as suggestive. If a PMCT is done before autopsy it can direct the pathologist to check for fractures of the vertebral bodies and direct his examination to an anterior approach that did not alter the findings.…”

“…[20][21][22][23][24] These fractures are difficult to detect in both conventional and digital radiography and PMCT improves the accuracy of cervical spine examinations and may provide useful assistance to a forensic pathologist in determining injuries suffered by trauma victims and the cause of death. 12,25,26 Generally the presence of a cervical spine injury should prompt an investigation with PMCT because the three-dimensional reconstruction of bone fractures can improve diagnostic accuracy. 26,27 But we have also to consider that the frequency of atlanto-axial rotatory subluxations (AARS) may be overestimated, in fact it may represent a common finding in CT-examinations of human corpses.…”

“…12,25,26 Generally the presence of a cervical spine injury should prompt an investigation with PMCT because the three-dimensional reconstruction of bone fractures can improve diagnostic accuracy. 26,27 But we have also to consider that the frequency of atlanto-axial rotatory subluxations (AARS) may be overestimated, in fact it may represent a common finding in CT-examinations of human corpses. This has to be considered a normal finding of a physiological post-mortem position with head rotation, as long as the AARS is not exceeding the rotation of the head, occurs ipsilateral and further signs of trauma are lacking or bone fractures as in our case.…”

“…These fractures are difficult to detect in both conventional and digital radiography and PMCT improves the accuracy of cervical spine examinations and may provide useful assistance to a forensic pathologist in determining injuries suffered by trauma victims and the cause of death. 12,25,26…”

Nasal Septum Defects Detected on Postmortem Computed Tomography

“…The PMCT as a noninvasive supplement to traditional autopsy can reveal small but relevant findings, which may go undetected during the external examination of the body or during autopsy. [17][18][19][20][21][22] A nasal septum defect may be such a finding, as clinical examination of the nose and the nasal cavities may be difficult, especially in cases of advanced decomposition with maggots' infestation or cases of severe facial trauma. The PMCT can easily and quickly reveal septal defects and allows further detailed investigation of its characteristics, like its edges' morphology and the presence of insects in the region.…”