Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas

Berger, Nicole; Ebert, Lars C; Ampanozi, Garyfalia; Flach, Patricia M; Gascho, Dominic; Thali, Michael J; Ruder, Thomas (2015). Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas. Forensic science, medicine, and pathology, 11(1), pp. 40-46. Springer 10.1007/s12024-014-9642-8

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PURPOSE The aim of this study was to investigate if (1) the volume of subdural hematomas (SDH), midline shift, and CT density of subdural hematomas are altered by postmortem changes and (2) if these changes are dependent on the postmortem interval (PMI). MATERIALS AND METHODS Ante mortem computed tomography (AMCT) of the head was compared to corresponding postmortem CT (PMCT) in 19 adults with SDH. SDH volume, midline shift, and hematoma density were measured on both AMCT and PMCT and their differences assessed using Wilcoxon-Signed Rank Test. Spearman's Rho Test was used to assess significant correlations between the PMI and the alterations of SDH volume, midline shift, and hematoma density. RESULTS Mean time between last AMCT and PMCT was 109 h, mean PMI was 35 h. On PMCT mean midline displacement was decreased by 57% (p < 0.001); mean SDH volume was decreased by 38% (p < 0.001); and mean hematoma density was increased by 18% (p < 0.001) in comparison to AMCT. There was no correlation between the PMI and the normalization of the midline shift (p = 0.706), the reduction of SDH volume (p = 0.366), or the increase of hematoma density (p = 0.140). CONCLUSIONS This study reveals that normal postmortem changes significantly affect the extent and imaging characteristics of subdural hematoma and may therefore affect the interpretation of these findings on PMCT. Radiologists and forensic pathologists who use PMCT must be aware of these phenomena in order to correctly interpret PMCT findings in cases of subdural hemorrhages.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ruder, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1556-2891

Publisher:

Springer

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

21 Mar 2016 10:35

Last Modified:

07 Aug 2017 13:22

Publisher DOI:

10.1007/s12024-014-9642-8

PubMed ID:

25566767

BORIS DOI:

10.7892/boris.77234

URI:

https://boris.unibe.ch/id/eprint/77234

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