Sudden unexpected death owing to unilateral medial medullary infarction with early involvement of the respiratory center
| Autor: | Koshi Kinoshita, Koji Yoshida, Naoki Nishida, Yukiko Hata |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Nucleus ambiguus
Medulla Oblongata Brain Stem Infarctions business.industry Medial lemniscus Respiratory center Infarction Anatomy Middle Aged Respiratory Center medicine.disease Pathology and Forensic Medicine Issues ethics and legal aspects Death Sudden Cardiac medicine.anatomical_structure Coagulative necrosis Dorsal respiratory group Inferior olivary nucleus Medulla oblongata Humans Medicine Female Autopsy business |
| Zdroj: | Legal Medicine. 16:146-149 |
| ISSN: | 1344-6223 |
| DOI: | 10.1016/j.legalmed.2014.01.006 |
| Popis: | A 64-year-old woman was found dead in her home. At autopsy, although relatively fresh bruises were found on her body, no lethal injury was observed in an internal observation. Mild edematous swelling of the right half of the medulla oblongata was observed. There was acute medial medullary infarction (MMI), which mainly involved the nucleus hypoglossi, medial lemniscus, hypoglossal root, inferior olivary nucleus, and pyramidal tract. Subacute infarction of the lower part of the cerebellum was also found, and severe atherosclerosis of the right vertebral artery containing thrombi was found as the culprit lesion. Immunohistochemistry using amyloid precursor protein (APP) was positive in neuronal tissue in the nucleus ambiguus, despite not showing coagulative necrosis in the nucleus. Therefore, acute ischemic necrosis of the nucleus ambiguus, which is considered to be a component of the dorsal respiratory group, may be a significant finding for her expected death. Immunohistochemistry of APP may be useful for confirming the precise extent of acute ischemia in brain stem infarction, such as unilateral MMI. |
| Databáze: | OpenAIRE |
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