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Brain-Stem Laceration and Blunt Rupture of Thoracic Aorta: Is the Intrapleural Bleeding Postmortem in Origin?An Autopsy Study

Živković, Vladimir MD, MSc; Nikolić, Slobodan MD, PhD; Babić, Dragan MD, PhD; Juković, Fehim MD

The American Journal of Forensic Medicine and Pathology: December 2011 - Volume 32 - Issue 4 - p 364–367
doi: 10.1097/PAF.0b013e3181d3d9d4
Original Articles

Some of the fatally injured car occupants could have had both blunt rupture of thoracic aorta with great amount of intrapleural blood, and pontomedullar laceration of brain-stem as well, with both injuries being fatal. The aim of this study was to answer if all intrapleural bleeding in these cases was antemortem, or the bleeding could also be partially postmortem. We observed the group of 66 cases of blunt aortic rupture: 21 case with brain-stem laceration, and 45 cases without it. The average amount of intrapleural bleeding in cases without brain-stem laceration (1993 ± 831 mL) was significantly higher than in those with this injury (1100 ± 708 mL) (t = 4.252, df = 64, P = 0.000). According to our results, in cases of the thoracic aorta rupture with concomitant brain-stem laceration, the amount of intrapleural bleeding less than 1500 mL, should be considered mostly as postmortem in origin, and in such cases, only the brain-stem injury should be considered as cause of death.

From the *Institute of Forensic Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia; †Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia; and ‡Department of Forensic Medicine, The County Hospital of the City of Novi Pazar, Novi Pazar, Serbia.

Manuscript received March 18, 2009; accepted July 28, 2009.

The authors report no conflicts of interest.

Reprints: Vladimir Živković, MD, MSc, Institute of Forensic Medicine, 31a Deligradska str., 11000 Belgrade, Serbia. E-mail:

© 2011 by Lippincott Williams & Wilkins.