Header

UZH-Logo

Maintenance Infos

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


Berger, Nicole; Ebert, Lars C; Ampanozi, Garyfalia; Flach, Patricia M; Gascho, Dominic; Thali, Michael J; Ruder, Thomas D (2015). Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas. Forensic Science, Medicine, and Pathology, 11(1):40-46.

Abstract

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 109 h, mean PMI was 35 h. 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.

Abstract

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 109 h, mean PMI was 35 h. 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.

Statistics

Citations

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:340 Law
610 Medicine & health
Language:English
Date:2015
Deposited On:16 Jan 2015 13:46
Last Modified:08 Dec 2017 10:21
Publisher:Springer
ISSN:1547-769X
Publisher DOI:https://doi.org/10.1007/s12024-014-9642-8
PubMed ID:25566767

Download

Full text not available from this repository.
View at publisher