Forensic Pathological Analysis of Death from Cerebrovascular Malformation_West China Medical Journal

Authors：

 YangYu ¹ , LiuYuan ¹ , ChenXiameng ¹ , ZhuHaibiao ² , ZhuPeng ³ ,  GuanPeng ¹

1. Department of Forensic Pathology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Institute of Evidence Law and Forensic Science, China University of Political Science and Law, Beijing 100088, P. R. China;
3. Technology Department, the People's Procuratorate of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

GuanPeng, Email: guanpengcn@yahoo.com

Keywords：

Cerebrovascular malformation; Forensic pathology; Medical dispute; Injury-disease relationship

DOI：

10.7507/1002-0179.201600336

Video：

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Objective To provide references in the forensic identification of injury and cerebrovascular malformation involved death cases, and to reduce the relevant medical dispute by exploring the forensic pathological features, identification of medical dispute as well as relationship between injury and disease. Methods We collected 33 cases of cerebrovascular malformation from January 2006 to December 2014 in West China Center of Forensic Medicine, including details of cases, clinical medical record and forensic pathology examination, and then the cases were retrospectively analyzed. Results In the 33 cases, the average age of the individuals was 37.4 years old, and the male/female ratio was 23/10. Nineteen patients (57.6%) died within 1 hour. Seventeen patients with mixed pathological type of cerebrovascular malformation dominated (51.5%). Medical dispute happened in 7 cases (21.1%), 4 of which were identified to be led by medical fault and 3 with no medical fault. Relationship between injury and disease was analyzed in 11 cases (33.3%), in which injury was identified to take full responsibility in 1 case, inductive cause of death in 9 cases, and no relationship between injury and death in 1 case. Conclusion Comprehensive and systematic investigation of forensic pathology plays an important role in the proper settlement of medical disputes as well as the identification of cause of death and relationship between injury and disease.

Citation： YangYu, LiuYuan, ChenXiameng, ZhuHaibiao, ZhuPeng, GuanPeng. Forensic Pathological Analysis of Death from Cerebrovascular Malformation. West China Medical Journal, 2016, 31(7): 1235-1239. doi: 10.7507/1002-0179.201600336 Copy

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1. 杭振鑣, 陳代云, 任安文. 腦血管意外180例尸檢資料的臨床病理分析[J]. 中華醫學雜志, 1998, 78(3):213-215.
2. 孫久君. 腦血管畸形的治療進展[J]. 醫學綜述, 2013, 19(22):4129-4132.
3. 劉建民. 對腦動靜脈畸形的若干思考[J]. 中國腦血管病雜志, 2006, 3(7):295-296, 306.
4. 趙劍婷, 車振勇, 呂發金, 等. 腦血管畸形的VCTDSA研究[J]. 中國實用神經病雜志, 2010, 1(9):23-25.
5. 王遠華, 陳剛. 38例腦血管畸形出血開顱手術治療分析[J]. 當代醫學, 2014, 20(1):78.
6. 丁曉, 李智斌, 黃戈. 腦血管畸形急性出血外科治療效果分析[J]. 2012, 19(19):32-33.
7. 曾銘偉. 腦血管畸形破裂出血誤診1例醫療糾紛司法鑒定思考[J]. 交通醫學, 2013, 27(6):662-663.
8. 劉志偉, 于曉軍, 呂俊耀. 顱腦外傷后小腦血腫死亡死因分析 1例[J]. 法醫學雜志, 2014, 30(6):497-498.
9. 甘建一, 梁安文, 朱金生. 腦血管畸形出血死亡的法醫病理學分析[J]. 中國司法鑒定, 2006(5):53-56.
10. Bergstrand A, Hoeoek O, Lidvall H. Vascular malformations of the spinal cord[J]. Acta Neurologica Scandinavica, 1964, 40(2):169-183.
11. Mccormick WF. The pathology of vascular ("arteriovenous") malformations[J]. J Neurosurg, 1966, 24(4):807-816.
12. Mccormick WF, Hardman JM, Boulter TR. Vascular malformations ("angiomas") of the brain, with special reference to those occurring in the posterior fossa[J]. J Neurosurg, 1968, 28(3):241-251.
13. Awad I, Robinson JR, Mohanty S, et al. Mixed vascular malformations of the brain:clinical and pathogenic considerations[J]. Neurosurgery, 1993, 33(2):179-188.
14. 劉承基, 凌鋒. 腦脊髓血管外科學[M]. 北京:中國科學脊髓出版社, 2013:398-405.
15. 陳星榮, 沈天真. 腦血管畸形的分類[J]. 中國醫學計算機成像雜志, 2000, 6(6):40-43.
16. 張元德, 王麗萍, 金友南, 等. 腦血管畸形39例病理[J]. 中風與神經疾病雜志, 1992, 9(2):101-102.
17. Walker EJ, Su H, Shen F, et al. Bevacizumab attenuates VEGF-induced angiogenesis and vascular malformationsin the adult mouse brain[J]. Stroke, 2012, 43(7):1925-1930.
18. 趙明光, 陳游力, 宋振全, 等. 血管生長相關因子在腦動靜脈血管畸形發生發展過程中的生物學效應[J]. 中國臨床康復, 2003, 9(1):73-75.
19. 袁紫剛, 徐錦芳. PTEN/PI3K/AKT信號通路與腦血管畸形血管生成的研究進展[J]. 國際神經病學神經外科學雜志, 2011, 38(5):463-467.
20. 劉鏡文, 魏茂富, 邱小靈. P16在腦血管畸形中的表達及其意義[J]. 中國醫學創新, 2013, 10(19):78-79.

West China Medical Journal

Forensic Pathological Analysis of Death from Cerebrovascular Malformation

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