[A case report of acute death caused by hyperextension injury of neck].

We report an autopsy case of acute death from an upper cervical spinal cord injury caused by hyperextension of the neck. A 59-year-old drunken man who had been suffering from cervical spondylosis was slapped in the face, fell flat on his face, and remained as such for 4 hours. The victim was carried to a hospital, he had already been dead on arrival. Although he received an intensive care, he remained unconscious for 12 hours until a cardiac arrest. The findings of an autopsy were as follows: Externally, excoriation on the forehead and the left eyebrow and slight subcutaneous hemorrhage in the dorsum of the nose were observed. The intervertebral disk and the anterior longitudinal ligament between the 5th and 6th cervical vertebrae were severed, and a lot of bleeding in the region of the injuries was observed. The 6th cervical spinous process was fractured in the direction to a major axis. A part of the posterior root filaments was torned and the bleeding points could be seen on the front of the 6th cervical spinal cord. In the cross section of the 6th cervical spinal cord, the typical hemorrhagic necrosis could be recognized surrounding the central canal, whereas the similar finding was observed at the second cervical spinal cord. On the histopathological examinations, in C2, C5-C6 regions marked ischemic changes and hemorrhagic necrosis could be observed. From these post-mortem results, we diagnosed that the victim died from an upper spinal cord damage due to a stretching consequence of the hyperextentional injury.