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Could Postmortem Hemorrhage Occur in the Brain?: A Preliminary Study on the Establishment and Investigation of Postmortem Hypostatic Hemorrhage Using Rabbit Models

Xiang, Lei MD; Zhou, Gengyin MD; Su, Peng MD; Xia, Shujun; Han, Bo MD, PhD; Wang, Yan; Zhang, Tingguo MD

The American Journal of Forensic Medicine and Pathology: June 2013 - Volume 34 - Issue 2 - p 147–149
doi: 10.1097/PAF.0b013e31828877f0
Original Articles

Objective The aim of this study was to explore whether postmortem hemorrhage can occur in brain tissue using rabbit models.

Methods The rabbits killed by air embolism were randomly divided into the horizontal-position group and the upside-down group. Autopsy was performed after 48 hours, and the brains were investigated with macroscopic assessment and histologic examination.

Results Macroscopically, congestion of vessels on the surface of the brain was identified in all the subjects in both groups. Microscopically, the presence of multifocal extravascular red blood cell aggregation was observed in brain parenchyma and subarachnoid space in the upside-down group. In contrast, no leakage of extravascular red blood cells was observed in the brain parenchyma and the subarachnoid space in the horizontal-position group.

Conclusions Hypostatic and leakage bleeding can occur in sites of subarachnoid space and brain parenchyma of rabbits after death by nonforce with a certain period and certain position of the placement. This type of hemorrhage is challenging to differentiate from traumatic hemorrhage in pathologic practice. To avoid misdiagnosis, the clinical pathologists should keep in mind that the possibility of postmortem hypostatic hemorrhage needs to be ruled out when the diagnosis of subarachnoid hemorrhage or cerebral hemorrhage is established.

From the Department of Pathology, School of Medicine, Shandong University, Jinan, China.

Manuscript received August 15, 2011; accepted January 16, 2012.

The authors report no conflicts of interest.

Reprints: Tingguo Zhang, Department of Pathology, School of Medicine, Shandong University, Jinan, 250012, China. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.