Gitto Lorenzo, Bolino Giorgio, Cina Stephen J
Department of Anatomy, Histology, Forensic Medicine, & Orthopedics, Sapienza University, Viale Regina Elena 336, 00185, Rome, Italy.
Forensic Pathology Consultant, Cina and Cina Forensic Consulting, PC, 4883 Valley Oak Drive, Loveland, CO.
J Forensic Sci. 2018 May;63(3):947-953. doi: 10.1111/1556-4029.13626. Epub 2017 Aug 23.
Deaths due to meningiomas are routinely diagnosed in clinical practice because this neoplasm tends to present with the typical progression of neurological deficits. On the other hand, sudden unexpected deaths due to meningiomas are rarely described in the literature. The study presents six fatal cases of previously undiagnosed intracranial meningiomas from the Cook County Medical Examiner's Office from 1998 to 2014. The most common explanation of the mechanism of sudden death due to intracranial neoplasms is a rapid increase in intracranial pressure produced by the mass effect of the neoplasm. Other mechanisms of death include acute intracranial and intratumoral hemorrhage, and benign neoplasms that grow in the vicinity of vital centers altering neural discharge in autonomic pathways leading to cardiac suppression or lethal arrhythmia. Forensic pathologists must keep in mind that sudden unexpected death caused by intracranial meningiomas, although extremely rare, may be encountered in the forensic setting.
在临床实践中，因脑膜瘤导致的死亡通常能够被诊断出来，因为这种肿瘤往往会呈现出典型的神经功能缺损进展情况。另一方面，文献中很少描述因脑膜瘤导致的意外猝死。该研究展示了1998年至2014年期间库克县法医办公室的6例先前未被诊断出的颅内脑膜瘤致死病例。颅内肿瘤导致猝死的最常见机制解释是肿瘤的占位效应引起颅内压迅速升高。其他死亡机制包括急性颅内和肿瘤内出血，以及生长在重要中枢附近的良性肿瘤改变自主神经通路中的神经放电，导致心脏抑制或致命性心律失常。法医病理学家必须牢记，颅内脑膜瘤引起的意外猝死虽然极为罕见，但在法医环境中可能会遇到。
