Dettmeyer R, Schmidt P, Madea B
Institute of Forensic Medicine, University of Bonn, Germany.
Forensic Sci Int. 1998 Jun 22;94(3):161-6. doi: 10.1016/s0379-0738(98)00062-0.
The autopsy findings from two rare cases of sudden death concerning a 31- and a 44-year-old woman are reported. Autopsy and morphological examination revealed a dissection of the aorta but no rupture into the pericardial sac. In both cases mucoid deposits in all layers of the media and rarefication of the elastic fibers were found, rendering cystic medionecrosis as the cause of the aortic dissection. In these unusual cases, only a very small intimal tear was present, but no blood in the dissected aortic wall. Evidence of left ventricular hypertrophy and a history of hypertension were reported in both cases. No extension of the aortic dissections into the left or right coronary artery and no other clinical or pathological findings associated with aortic dissection were present. Cystic medionecrosis was the cause of the aortic dissection in these cases. The mechanism of death in both cases is discussed.
报告了两例罕见的猝死病例的尸检结果，死者分别为一名31岁和一名44岁的女性。尸检和形态学检查显示主动脉夹层，但未破裂进入心包腔。在两例病例中，均发现中膜各层有黏液样沉积物以及弹性纤维稀疏，导致囊性中层坏死成为主动脉夹层的原因。在这些不寻常的病例中，仅存在非常小的内膜撕裂，但夹层主动脉壁内无血液。两例病例均报告有左心室肥厚和高血压病史。主动脉夹层未延伸至左或右冠状动脉，也未发现与主动脉夹层相关的其他临床或病理表现。囊性中层坏死是这些病例中主动脉夹层的原因。讨论了两例病例的死亡机制。
