Epidural herniation of the cerebral tissue in a burned body: a case report

A case in which herniation of the cerebral tissue was seen in the epidural space of a burned body is reported. The dead, burned body of an 8-year-old female was found in her burnt-out house. Externally, the body (except the back) was burned to the third or fourth degree, although there was no injury, specifically no skull fracture due to a mechanical force. Internally, much soot deposit was observed in the trachea, main bronchi and peripheral bronchioles. A 9.5 cm x 6.0 cm, thermo-coagulated, yellowish-white mass was unexpectedly found lying on the dura mater of the left temporal lobe. Histologically, H&E stain showed that the mass was thermo-coagulated cerebral tissue, although neither intra-cerebral haemorrhage nor cerebral contusion was found. The carboxyhaemoglobin (CO-Hb) concentration in the intracardiac blood was 83%. The cause of her death was diagnosed as death due to fire, based on the autopsy findings described above and the high CO-Hb concentration value. Therefore, the unexpected entry of the cerebral tissue into the epidural space was considered to be one of the morphological changes due to the local action of heat; the authors propose that such a postmortem change should be called 'heat brain herniation'.