Case ReportsFatal Intracerebral Hemorrhage During “Muay Thai” in a 21-Year-Old Man With Undiagnosed Acute Myeloid Leukemia Spontaneous or Posttraumatic Hemorrhage?Caputo, Fiorella MD∗; Barranco, Rosario MD∗; Fraternali Orcioni, Giulio MD†; Frigiolini, Francesca Maria Elena MD∗; Ventura, Francesco MD, PhD∗Author Information From the ∗Department of Legal and Forensic Medicine, University of Genova, Genova †Department of Clinical Pathology, S. Croce e Carle Hospital, Cuneo, Italy. Manuscript received December 27, 2019; accepted April 20, 2020. The authors report no conflict of interest. Reprints: Francesco Ventura, Department of Legal Medicine, University of Genova, via De’ Toni 12, 16132 Genova, Italy. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: September 2020 - Volume 41 - Issue 3 - p 213-216 doi: 10.1097/PAF.0000000000000575 Buy Metrics Abstract Acute myeloid leukemia (AML) is characterized by the rapid growth of abnormal white blood cells in the bone marrow that interferes with the production of normal blood cells. This disease is burdened by a high risk of bleeding complications involving central nervous system hemorrhages, purpura, gingival bleeding, and gastrointestinal bleeding. In this article, the authors report a case of a fatal intracerebral hemorrhage in a 21-year-old man who was affected by an undiagnosed AML. The subject practiced a combat sport (Muay Thai), and 2 days before his last training, he was involved in a fight where the aggressor punched him in the face; however, after the fight, he did not claim of any symptoms. The current case highlights the importance of the role of the forensic pathologist because only through a careful and complete circumstantial, autoptic, and histological analysis it is possible to date the origin of a cerebral hemorrhage and establish whether it is spontaneous or posttraumatic in subjects with undiagnosed preexisting diseases. Through an integrated study, it is also important to date the lesion and identify the traumatic event responsible of the bleeding. Finally, this case has a relevant clinical importance relatively to sports medicine, where it would be appropriate that athletes undergo blood test as a preventive measure. In fact, in presence of an acute hematological disease, such as AML, even mild traumatic injuries may be fatal. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.