Jaster J Howard, Ottaviani Giulia, Matturri Luigi, Lavezzi Anna Maria, Zamecnik Josef, Smith Thomas W
London Corporation, Grand Prairie, TX, USA.
Am J Forensic Med Pathol. 2008 Dec;29(4):371-4. doi: 10.1097/PAF.0b013e3181847dfc.
The sudden unexpected death of a person believed healthy has occasionally been followed by a detailed postmortem examination that revealed no cause of death except for the unexpected presence of a medullary brain lesion. Our review of all available cases of sudden unexpected death related to medullary brain lesions (SUD-MBL) revealed the absence of any specific constellation of ante-mortem disease characteristics, together with the finding that major motor and sensory pathways were grossly preserved in most cases. The wide variety in ages of the victims, and in specific types of tissue pathology affecting the medulla, makes this illness extremely difficult to anticipate when the medullary lesions are not otherwise known to exist during life. SUD-MBL may be a specific clinico-neuropathologic disease entity, having significant importance for forensic investigators trying to establish the cause of sudden unexpected death in a victim of any age. Because victims often harbor their medullary lesions for days or weeks before SUD-MBL, clinical physicians as well need to consider the possibility of medullary brain involvement by any disease process, neurologic or systemic, while managing their patients.
一个看似健康的人突然意外死亡，偶尔会在详细的尸检后发现，除了意外出现的延髓脑病变外，没有其他死因。我们对所有与延髓脑病变相关的突然意外死亡病例（SUD-MBL）进行了回顾，发现生前没有任何特定的疾病特征组合，同时还发现大多数病例中主要的运动和感觉通路大体上得以保留。受害者年龄各异，延髓受影响的组织病理学具体类型也各不相同，这使得在生前不知存在延髓病变的情况下，极难预测这种疾病。SUD-MBL可能是一种特定的临床神经病理学疾病实体，对试图确定任何年龄受害者突然意外死亡原因的法医调查人员具有重要意义。由于受害者在SUD-MBL发生前通常已患有延髓病变数天或数周，临床医生在治疗患者时也需要考虑任何神经或全身性疾病过程累及延髓脑的可能性。
