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第三脑室胶样囊肿导致的猝死:三例尸检有特殊征象的报告

Sudden death due to a colloid cyst of the third ventricle: report of three cases with a special sign at autopsy.

作者信息

Demirci Serafettin, Dogan Kamil Hakan, Erkol Zerrin, Gulmen Mete Korkut

机构信息

Selcuk University, Meram Medical School, Department of Forensic Medicine, Akyokus Mevkii, 42080 Meram, Konya, Turkey.

出版信息

Forensic Sci Int. 2009 Aug 10;189(1-3):e33-6. doi: 10.1016/j.forsciint.2009.04.016. Epub 2009 May 15.

Abstract

Colloid cysts of the third ventricle are rare benign cysts but they may be potentially life-threatening. Three cases of sudden death resulting from colloid cysts of the third ventricle are presented. The first and second cases were treated for migraine headaches. In the first case, the patient was a 24-year-old woman who presented to the hospital with a severe headache and was sent back home after medical treatment. Six hours later, she was found dead in her bed. The second case was a 21-year-old woman who experienced a severe headache, dizziness and vomiting 1 day prior to her death. She was transported to the hospital, where she was pronounced dead upon arrival. The third case was a 25-year-old man who experienced headaches and vomiting and was diagnosed with and medically treated for sinusitis. He lost consciousness and was taken to hospital, where he was pronounced dead on arrival. During the autopsy of all three cases, there was a grey transillumination area observed that occurred due to the stretching of tissue at the base of brain between the corpus mamillare and chiasma opticum. Dissection of the brain revealed a colloid cyst of the third ventricle. To avoid such fatal complications, prompt diagnosis using CT or MRI is essential in patients who have a long-standing history of intermittent headaches. During the autopsy of the sudden deaths of people with medical antecedents of headaches, if a grey color is observed between the chiasma opticum and the corpus mamillare in the base of the brain, a colloid cyst should be considered and this region should be dissected and examined carefully.

摘要

第三脑室胶样囊肿是罕见的良性囊肿,但可能有潜在生命危险。本文报告了3例因第三脑室胶样囊肿导致猝死的病例。第一例和第二例最初因偏头痛接受治疗。第一例患者为一名24岁女性,因剧烈头痛入院,经治疗后回家。6小时后,她被发现死在床上。第二例患者是一名21岁女性,在死亡前1天出现严重头痛、头晕和呕吐。她被送往医院,到达后被宣布死亡。第三例患者是一名25岁男性,出现头痛和呕吐,被诊断为鼻窦炎并接受了药物治疗。他失去意识后被送往医院,到达后被宣布死亡。在对所有3例病例进行尸检时,均观察到一个灰色透光区域,这是由于乳头体和视交叉之间脑底部组织的拉伸所致。对大脑进行解剖后发现第三脑室有一个胶样囊肿。为避免此类致命并发症,对于有长期间歇性头痛病史的患者,使用CT或MRI进行快速诊断至关重要。在对有头痛病史的猝死患者进行尸检时,如果在脑底部视交叉和乳头体之间观察到灰色区域,应考虑胶样囊肿,并应对该区域进行仔细解剖和检查。

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