[Fatal epidural hemorrhage after a 2-week interval].

Area of Science:

• Neurology
• Forensic Pathology
• Trauma Surgery

Background:

• A 15-year-old female sustained a skull fracture from a fall, initially presenting with syncope and cerebral concussion.
• Despite initial recovery, she experienced sudden death two weeks post-accident.
• Autopsy revealed a fatal epidural hemorrhage as the cause of death.

Purpose of the Study:

• To report a rare case of fatal epidural hemorrhage due to a reruptured traumatic pseudoaneurysm of the middle meningeal artery.
• To discuss the morphological findings associated with this injury.
• To examine the medicolegal implications, particularly concerning conservative management of epidural hematomas.

Main Methods:

• Case report detailing a fatal head injury.
• Autopsy and morphological examination to determine the cause of death.
• Review of medical literature and legal precedents regarding epidural hemorrhage management.

Main Results:

• The cause of death was an epidural hemorrhage originating from a reruptured traumatic pseudoaneurysm of the middle meningeal artery.
• Morphological findings confirmed the pseudoaneurysm as the source of bleeding.
• The case raises questions about the management of epidural hematomas, especially with evolving conservative treatment options.

Conclusions:

• Ruptured traumatic pseudoaneurysms of the middle meningeal artery can lead to delayed, fatal epidural hemorrhage.
• Accurate diagnosis and timely intervention are critical in managing traumatic head injuries.
• Medicolegal considerations are important when discussing treatment strategies for epidural hematomas.