An autopsy case of misdiagnosis based on postmortem computed tomography findings

Area of Science:

• Forensic Pathology
• Radiology
• Trauma Medicine

Background:

• Postmortem Computed Tomography (CT) is increasingly used to supplement forensic investigations.
• Clinical diagnosis based on initial CT findings can sometimes differ from autopsy results.

Observation:

• A middle-aged male cyclist was found deceased.
• Initial CT suggested traumatic intracerebral hemorrhage and frontal bone fracture.
• Forensic autopsy revealed no acute head trauma but an old frontal lobe defect and a ruptured left renal artery.

Findings:

• The apparent intracerebral hemorrhage was attributed to bleeding into an old frontal lobe defect.
• The actual cause of death was massive hemorrhage from a disrupted left renal artery.
• Discrepancies between pre-autopsy CT and postmortem examination highlight potential diagnostic challenges.

Implications:

• This case underscores the critical importance of integrating autopsy findings with imaging data.
• Over-reliance on postmortem CT without thorough autopsy can lead to misdiagnosis in forensic cases.
• Careful interpretation of postmortem CT is essential to avoid diagnostic errors in cause of death determination.