Diagnosis of stroke death by using postmortem CT scan as autopsy imaging

Abstract

Background & Purpose: The diagnosis of the causes of sudden death using autopsy imaging has been in practice for many years. However, there are a few reports on autopsy imaging mainly focused on the stroke death. Postmortem CT scan as autopsy imaging in the emergency department reveals the trend in the causes of sudden death and the percentage of the stroke death in our autopsy imaging series. Methods: Postmortem CT scans from the head to the pelvis was conducted in 547 deceased cases between 2012 and 2014. Of them, the police requested postmortem CT scan for 246 cases. Among 337 patients taken by an ambulance as a cardiopulmonary arrest in our emergency department, 301 cases (89%) were conducted postmortem CT scan. Results: In the 547 autopsy-imaging series, 98 cases (18%) were diagnosed with internal death due to the several causes and 112 (20%) were external death. In the other 337 cases (62%), the cause of death could not be detected using postmortem CT scan. Twenty-nine cases (5%) were diagnosed with death from the stroke. Of them, 15 cases were diagnosed with subarachnoid hemorrhage, 13 were intracranial hemorrhage (4, pontine hemorrhage; 3, thalamo-putaminal hemorrhage; 3, subcortical hemorrhage; 1, putaminal hemorrhage; 1, cerebellar hemorrhage; 1, intraventricular hemorrhage), and only one case was diagnosed with large cerebral infarction due to occlusion of the internal cerebral artery. Conclusion: The frequency of stroke death was only 5% in 547 autopsy-imaging series using postmortem CT scan.