Fulltext

Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas

Berger, Nicole ; Ebert, Lars ; Ampanozi, Garyfalia ; Flach, Patricia ; Gascho, Dominic ; Thali, Michael ; Ruder, Thomas

In: Forensic Science, Medicine, and Pathology, 2015, vol. 11, no. 1, p. 40-46

Aggiungi alla tua lista
    Titre
    • Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas
    Auteur
    • Berger, Nicole. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Ebert, Lars. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Ampanozi, Garyfalia. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Flach, Patricia. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Gascho, Dominic. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Thali, Michael. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    • Ruder, Thomas. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Forensic Science, Medicine, and Pathology, 2015, vol. 11, no. 1, p. 40-46. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331607
    Summary
    Purpose: The aim of this study was to investigate if (1) the volume of subdural hematomas (SDH), midline shift, and CT density of subdural hematomas are altered by postmortem changes and (2) if these changes are dependent on the postmortem interval (PMI). Materials and Methods: Ante mortem computed tomography (AMCT) of the head was compared to corresponding postmortem CT (PMCT) in 19 adults with SDH. SDH volume, midline shift, and hematoma density were measured on both AMCT and PMCT and their differences assessed using Wilcoxon-Signed Rank Test. Spearman's Rho Test was used to assess significant correlations between the PMI and the alterations of SDH volume, midline shift, and hematoma density. Results: Mean time between last AMCT and PMCT was 109h, mean PMI was 35h. On PMCT mean midline displacement was decreased by 57% (p<0.001); mean SDH volume was decreased by 38% (p<0.001); and mean hematoma density was increased by 18% (p<0.001) in comparison to AMCT. There was no correlation between the PMI and the normalization of the midline shift (p=0.706), the reduction of SDH volume (p=0.366), or the increase of hematoma density (p=0.140). Conclusions: This study reveals that normal postmortem changes significantly affect the extent and imaging characteristics of subdural hematoma and may therefore affect the interpretation of these findings on PMCT. Radiologists and forensic pathologists who use PMCT must be aware of these phenomena in order to correctly interpret PMCT findings in cases of subdural hemorrhages.