Egger Coraline, Dédouit Fabrice, Schrag Bettina, Hanquinet Sylviane, Fracasso Tony
University Center of Legal Medicine Lausanne - Geneva (CURML), Unit of Forensic Medicine and Imaging, Rue Michel-Servet 1, 1211 Geneva, Switzerland.
Service of Legal Medicine, Hospital of Rangueil, Avenue du Professeur Jean Poulhès 1, 31400 Toulouse, France.
Forensic Sci Res. 2023 Jan 13;8(1):79-83. doi: 10.1093/fsr/owad002. eCollection 2023 Mar.
The authors present a medico-legal autopsy case of hydranencephaly in a male preterm newborn, fully documented by postmortem unenhanced and enhanced imaging techniques (postmortem computed tomography and postmortem magnetic resonance imaging). Hydranencephaly is a congenital anomaly of the central nervous system, consisting in almost complete absence of the cerebral hemispheres and replacement of the cerebral parenchyma by cerebrospinal fluid, rarely encountered in forensic medical practice. A premature baby was born during the supposed 22nd and 24th week of pregnancy in the context of a denial of pregnancy without any follow-up. The newborn died a few hours after birth and medico-legal investigations were requested to determine the cause of death and exclude the intervention of a third person in the lethal process. The external examination revealed neither traumatic nor malformative lesions. Postmortem imaging investigations were typical of hydranencephaly, and conventional medico-legal autopsy, neuropathological examination, and histological examination confirmed a massive necrotic-haemorrhagic hydranencephaly. This case represents in itself an association of out-of-the-ordinary elements making it worthy of interest.
Postmortem unenhanced and enhanced imaging techniques (computed tomography and magnetic resonance imaging) were performed as complementary examination to conventional medico-legal investigations.Postmortem angiography of a preterm newborn is possible with catheterization of the umbilical blood vessels.Hydranencephaly is a congenital anomaly of the central nervous system, consisting in almost complete absence of the cerebral hemispheres and replacement of the brain by cerebrospinal fluid, for which several aetiologies have been postulated.
作者介绍了一例男性早产新生儿积水性无脑畸形的法医学尸检病例，通过死后非增强和增强成像技术（死后计算机断层扫描和死后磁共振成像）进行了全面记录。积水性无脑畸形是一种中枢神经系统的先天性异常，其特征是几乎完全没有大脑半球，脑实质被脑脊液替代，在法医学实践中很少见。一名早产儿在怀孕第22至24周期间出生，母亲否认怀孕且未进行任何随访。新生儿出生后数小时死亡，应要求进行法医学调查以确定死因并排除第三方在致死过程中的干预。外部检查未发现创伤性或畸形性病变。死后成像检查显示为典型的积水性无脑畸形，传统的法医学尸检、神经病理学检查和组织学检查证实为大规模坏死出血性积水性无脑畸形。该病例本身包含一系列不同寻常的因素，值得关注。
进行死后非增强和增强成像技术（计算机断层扫描和磁共振成像）作为传统法医学调查的补充检查。通过脐血管插管对早产新生儿进行死后血管造影是可行的。积水性无脑畸形是中枢神经系统的先天性异常，其特征是几乎完全没有大脑半球，脑实质被脑脊液替代，对此已提出多种病因。
