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Forensic Science, Medicine and Pathology

, Volume 14, Issue 4, pp 536–540 | Cite as

Delayed rupture of a vertebral artery laceration: a case report and challenges for the forensic pathologist

  • Daniel S. Smyk
  • Jayantha C. Herath
Case Report

Abstract

Vertebral artery laceration/dissection (VALD) resulting in fatal subarachnoid hemorrhage (SAH) is a rare, but well-known phenomenon encountered in the forensic setting. Delayed ruptures are exceptionally rare, and pose several challenges to the forensic pathologist. In this paper we present a case of a 47-year-old male who collapsed suddenly following recent complaints of a headache and a reported seizure. He had a reported history of potential head trauma that occurred several days prior. Attempts at resuscitation were unsuccessful, and an autopsy examination was ordered. Computer tomography (CT), autopsy, histological and ancillary studies were performed. External examination showed mild, healing trauma to the head and upper limbs, and pre-autopsy CT demonstrated a SAH. Examination of the brain showed basally oriented SAH, and there was a laceration of the left vertebral artery. Histological examination demonstrated a delayed rupture, and there was no significant blood vessel abnormality. Molecular testing was negative for collagen vascular disorders. Delayed rupture of the vertebral arteries following head trauma is rare. The presence of remote and/or mild trauma may be difficult to establish at autopsy, and it is important to identify underlying aortopathies. Several autopsy techniques and ancillary studies should be performed in these cases.

Keywords

Vertebral artery dissection Vertebral artery laceration Subarachnoid hemorrhage Forensic radiology Computer tomography Molecular autopsy 

Abbreviations

CT

Computer tomography

SAH

Subarachnoid hemorrhage

VALD

Vertebral artery laceration/dissection

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Laboratory Medicine and Pathology, Faculty of MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Ontario Forensic Pathology Service, Forensic Services and Coroner’s ComplexTorontoCanada
  3. 3.Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada

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