Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Tokyo Medical Examiner's Office, Tokyo, Japan.
Neuropathology. 2020 Oct;40(5):496-500. doi: 10.1111/neup.12661. Epub 2020 Jul 14.
Interhemispheric cysts are congenital, and usually present symptoms during childhood. However, they are occasionally detected in adults. These cystic lesions are sometimes associated with defects of the corpus callosum. Although defects of the corpus callosum by themselves do not present clinical symptoms, they are often accompanied by other brain malformations. A man in his late 60s was found dead at the scene of a fire. At autopsy, his brain weighed 1223 g and had a large interhemispheric cyst, measuring 5.5 × 4.5 × 4.0 cm in size. The cyst contained clear fluid but was not connected to the ventricular system. On slices of the cerebrum, the corpus callosum did not connect the right and left cerebral hemispheres, and the right lateral ventricle was dilated. By the existence of the cyst, compressed by the cyst, the hemispheres were displaced on either side. Histologically, the cerebral parenchyma around the cyst was slightly edematous but structurally normal. Immunohistochemically, both glial fibrillary acidic protein and podoplanin were expressed in the cystic components. Thus, the cystic lesion was diagnosed as a glioependymal cyst. In this case, because the cyst was located at the interhemispheric space between the right and left frontal lobes, the individual experienced no obvious symptoms, despite its large size. The individual's brain malformations included the partial defect of the corpus callosum and the cyst. The dilation of the right lateral ventricle was considered to result from the location of the cyst. Under the influence of the cyst, the third ventricle was displaced downward, and one or both of the interventricular foramen were obstructed. The decedent had burns over his whole body. Burns to the epiglottis and soot in the airway were also observed. Volatile hydrocarbons, such as benzene and styrene, were detected in the blood. The percentage of carboxyhemoglobin levels in a total of hemoglobin levels were 19-25%. Therefore, the individual's cause of death was established as death by fire.
大脑半球间囊肿为先天性病变，通常在儿童时期出现症状。然而，在成年人中偶尔也会发现。这些囊性病变有时与胼胝体缺陷相关。虽然胼胝体缺陷本身没有临床表现，但常伴有其他脑畸形。一名 60 多岁的男性被发现死于火灾现场。尸检时，他的大脑重 1223 克，有一个大的大脑半球间囊肿，大小为 5.5×4.5×4.0 厘米。囊肿内含有清亮液体，但与脑室系统不连通。在大脑切片上，胼胝体没有连接左右大脑半球，右侧侧脑室扩张。由于囊肿的存在，半球被囊肿压迫而向两侧移位。组织学上，囊肿周围的脑实质稍有水肿，但结构正常。免疫组织化学染色显示，囊腔成分均表达胶质纤维酸性蛋白和 podoplanin。因此，囊性病变被诊断为神经胶质室管膜囊肿。在本例中，由于囊肿位于右侧和左侧额叶之间的大脑半球间间隙，尽管囊肿较大，但个体没有明显的症状。该个体的脑畸形包括胼胝体部分缺陷和囊肿。右侧侧脑室扩张被认为是由于囊肿的位置所致。在囊肿的影响下，第三脑室向下移位，一个或两个室间孔受阻。死者全身烧伤。还观察到会厌和气道内的烟尘烧伤。血液中检测到苯和苯乙烯等挥发性碳氢化合物。总血红蛋白中碳氧血红蛋白的百分比为 19-25%。因此，个体的死亡原因被确定为烧死。
