[Massive pulmonary brain tissue embolism]

A 20 year old woman with a severe head injury and rapidly increasing brain edema died 46 hours after the accident. There was clinical evidence of protracted shock and disseminated intravascular coagulation. The autopsy revealed a macro-embolization of brain tissue of the lungs with many central and intermediate lung artery branches occluded by cerebral tissue. Preconditions of the brain tissue embolism were a severe fracture of the skull including a traumatic rupture of the right sigmoid sinus, together with a local brain laceration and an extremely elevated intracranial pressure. Fibrin precipitations were prominent at the surfaces of the brain tissue emboli as well as in peripheral blood vessels of the lung; in the systemic circulation, intravascular coagulation was much less pronounced.