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

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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. 杭振镳, 陈代云, 任安文. 脑血管意外180例尸检资料的临床病理分析[J]. 中华医学杂志, 1998, 78(3):213-215.
2. 孙久君. 脑血管畸形的治疗进展[J]. 医学综述, 2013, 19(22):4129-4132.
3. 刘建民. 对脑动静脉畸形的若干思考[J]. 中国脑血管病杂志, 2006, 3(7):295-296, 306.
4. 赵剑婷, 车振勇, 吕发金, 等. 脑血管畸形的VCTDSA研究[J]. 中国实用神经病杂志, 2010, 1(9):23-25.
5. 王远华, 陈刚. 38例脑血管畸形出血开颅手术治疗分析[J]. 当代医学, 2014, 20(1):78.
6. 丁晓, 李智斌, 黄戈. 脑血管畸形急性出血外科治疗效果分析[J]. 2012, 19(19):32-33.
7. 曾铭伟. 脑血管畸形破裂出血误诊1例医疗纠纷司法鉴定思考[J]. 交通医学, 2013, 27(6):662-663.
8. 刘志伟, 于晓军, 吕俊耀. 颅脑外伤后小脑血肿死亡死因分析 1例[J]. 法医学杂志, 2014, 30(6):497-498.
9. 甘建一, 梁安文, 朱金生. 脑血管畸形出血死亡的法医病理学分析[J]. 中国司法鉴定, 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. 刘承基, 凌锋. 脑脊髓血管外科学[M]. 北京:中国科学脊髓出版社, 2013:398-405.
15. 陈星荣, 沈天真. 脑血管畸形的分类[J]. 中国医学计算机成像杂志, 2000, 6(6):40-43.
16. 张元德, 王丽萍, 金友南, 等. 脑血管畸形39例病理[J]. 中风与神经疾病杂志, 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. 赵明光, 陈游力, 宋振全, 等. 血管生长相关因子在脑动静脉血管畸形发生发展过程中的生物学效应[J]. 中国临床康复, 2003, 9(1):73-75.
19. 袁紫刚, 徐锦芳. PTEN/PI3K/AKT信号通路与脑血管畸形血管生成的研究进展[J]. 国际神经病学神经外科学杂志, 2011, 38(5):463-467.
20. 刘镜文, 魏茂富, 邱小灵. P16在脑血管畸形中的表达及其意义[J]. 中国医学创新, 2013, 10(19):78-79.

West China Medical Journal

Forensic Pathological Analysis of Death from Cerebrovascular Malformation

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