Silloca-Cabana Elizabeth O, Hathuc Vivian M, Harrison William T, Lantz Patrick E
Department of Pathology, Wake Forest Baptist Health, Medical Center Blvd., Winston Salem, NC, 27157.
Department of Pathology, Ascension Genesys Hospital, 1 Genesys Pkwy, Grand Blanc, MI, 48439.
J Forensic Sci. 2020 Mar;65(2):649-654. doi: 10.1111/1556-4029.14196. Epub 2019 Sep 25.
Fibromuscular dysplasia is an idiopathic, nonatheromatous, and noninflammatory arterial disease that most commonly affects the renal and carotid arteries. We report a child with subarachnoid and ocular hemorrhage associated with an aneurysm due to fibromuscular dysplasia. Computed tomography following a witnessed collapse revealed diffuse subarachnoid hemorrhage and severe cerebral edema. An autopsy confirmed the radiographic findings and detected bilateral retinal hemorrhages, optic nerve sheath hemorrhages, and a ruptured saccular aneurysm due to focal fibromuscular dysplasia involving the intracranial right vertebral artery. This case documents a fatal subarachnoid hemorrhage in a child with an intracranial saccular aneurysm caused by fibromuscular dysplasia. The associated retinal hemorrhages are easily detected by postmortem monocular indirect ophthalmoscopy.
纤维肌发育不良是一种特发性、非动脉粥样硬化性、非炎症性动脉疾病，最常累及肾动脉和颈动脉。我们报告一名儿童，因纤维肌发育不良导致动脉瘤，并发蛛网膜下腔出血和眼部出血。在一次目睹的晕倒后进行的计算机断层扫描显示弥漫性蛛网膜下腔出血和严重脑水肿。尸检证实了影像学检查结果，并发现双侧视网膜出血、视神经鞘出血，以及由于右侧颅内椎动脉局灶性纤维肌发育不良导致的囊状动脉瘤破裂。本病例记录了一名因纤维肌发育不良引起颅内囊状动脉瘤的儿童发生致命性蛛网膜下腔出血。死后通过单眼间接检眼镜检查很容易发现相关的视网膜出血。
