Smaller but denser postmortem changes alter the C

Authors: Nicole Berger Lars C Ebert Garyfalia Ampanozi Patricia M Flach Dominic Gascho Michael J Thali Thomas D Ruder

Publish Date: 2015/01/08

Volume: 11, Issue: 1, Pages: 40-46

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Abstract

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 WilcoxonSigned 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 densityMean time between last AMCT and PMCT was 109 h mean PMI was 35 h On PMCT mean midline displacement was decreased by 57  p  0001 mean SDH volume was decreased by 38  p  0001 and mean hematoma density was increased by 18  p  0001 in comparison to AMCT There was no correlation between the PMI and the normalization of the midline shift p = 0706 the reduction of SDH volume p = 0366 or the increase of hematoma density p = 0140This 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

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