ISSN: 0022-1198
CODEN: JFSCA
Published Online: 5 May 2004
Page Count: 2

Motor-Vehicle Collision-Related Death Due to Delayed-Onset Subarachnoid Hemorrhage Associated with Anticoagulant Therapy
Lopez, AE

White, CL
Southwestern Institute of Forensic Sciences, TX

Prahlow, JA
South Bend Medical Foundation and Indiana University School of Medicine - South Bend Center for Medical Education at the University of Notre Dame, IN

Barnard, JJ

Oeberst, JL
Southwestern Institute of Forensic Sciences, TX

(Received 18 October 2003; accepted 13 March 2004)

Abstract

Delayed deaths following injury are not rare. Various mechanisms may be responsible for such deaths, including pulmonary thromboembolism, fat embolism, infection, systemic inflammatory response syndrome, and delayed hemorrhage. In the present case, we describe a death due to delayed subarachnoid hemorrhage following a motor vehicle collision, wherein the hemorrhage occurred ten days after the incident, while the patient remained hospitalized for skeletal trauma. At no time prior to the hemorrhage did the victim show any symptoms of brain injury. Autopsy revealed basilar subarachnoid hemorrhage arising from a cerebral cortical contusion. There was no evidence of aneurysm or arteriovenous malformation. A significant underlying contributing factor in the delayed hemorrhage was the victim's chronic anticoagulant therapy, which was required because of a mechanical heart valve.

Keywords:
forensic science, complications of therapy, subarachnoid hemorrhage, anticoagulant therapy, delayed death

Paper ID: JFS2003349
DOI: 10.1520/JFS2003349
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