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SUDDEN UNEXPECTED DEATH DUE TO CEREBELLAR ASTROCYTOMA (PILOCYTIC ASTROCYTOMA): AN AUTOPSY CASE*

Year 2006, Volume: 20 Issue: 2, 79 - 84, 31.08.2006
https://izlik.org/JA69PE99GR

Abstract

Tumors of the central nervous system are among the rare causes of sudden and unexpected deaths. This case report describes the sudden and unexpected death of an otherwise healthy, 22- year-old male soldier from cerebellar astrocytoma due to hemorrhage in affected cerebellar hemisphere. He was admitted to an emergency room with headache and vomiting, subsequently became unresponsive to external stimuli and spontaneous respiration ceased. Initial diagnosis was subarachnoidal hemorrhage and encephalitis. After being connected to life support unit in the intensive care unit he was diagnosed as a hematoma in right cerebellar hemisphere. In spite of all efforts in the intensive care unit he was accepted as dead in the third day of admittance. Since he was under military service this case was accepted as forensic case and was sent to the Mortuary Department of Institute of Forensic Medicine of Turkey for autopsy. At autopsy there was no sign of trauma and other changes that might be responsible for death except for the hemorrhage in the right cerebellar hemisphere. Histological examination of the case revealed the diagnosis of cerebellar astrocytoma (pilocytic astrocytoma) and diffuse bleeding in the cerebellar tissue. We concluded that this hemorrhage in the cerebellum created pressure effect on the adjacent vital centers and was responsible for death. Although this tumor type is generally non-aggressive and slowly progressing, in this case it led to the bleeding within the tumor causing sudden unexpected death.

References

  • Barker DJP, Weller RO, Garfield JS. Epidemiology of primary tumors of the brain and spinal cord: a regional survey in Southern England. J Neurol Neurosurg Psychiatry, 1976; 39: 290-296.
  • Nelson JS, Parisi JE, Schochet SS. Principles and practice of neuropathology. Mosby, 1993: 123-124.
  • Clark GB, Henry JM, McKeever PE. Cerebral pilocytic astrocytoma. Cancer, 1985; 56: 1128.
  • Garica DM et al. Astrocytomas of the cerebellum in children. J Neurosurg, 1989; 71: 661-64.
  • Byard RW, Bourne AJ, Hanieh A. Sudden and unexpected death due to hemorrhage from occult central nervous system lesions. A pediatric autopsy study. Pediatr Neurosurg, 1991-92; 17(2): 88-94.
  • Lo S, Kish KK. Juvenile Pilocytic Astrocytoma in http:// www.emedicine.com/radio/topic367.htm
  • Tomlinson FH. Atypia and malignancy in pilocytic astrocytoma of the cerebellum: a clinicopathologic and flow cytometric study. J Neuropathol Exp Neurol, 1992; 51: 331.
  • Havlik DM, Becher MW, Nolte KB. Sudden death due to primary diffuse leptomeningeal gliomatosis. J Forensic Sci, 2001; 46(2): 392-395.
  • DiMaio SM, Dimaio VJ, Kirkpatrick JB. Sudden, unexpected deaths due to primary intracranial neoplasms. Am J Forensic Med Pathol, 1980; 1(1): 29-45.
  • Ellison D, Love S, Chinnelli L, Harding BN, Lowe J, Vinters HV eds. Astrocytic Neoplasms. In Neuropathology, 2nd ed. London, Mosby; 2004: 623-640.
  • Robbins SL, Kumar V. Basic Pathology. WB Saunders CO, 1987: 741-744.
  • Mesiwala AH, Avellino AM, Roberts TS, Ellenbogen RG. Spontaneous cerebellar hemorrhage due to juvenile pilocytic astrocytoma: case report and review of the literature. Pediatr Neurosurg, 2001; 34(5): 235-8.
  • Gleckman AM, Smith TW. Sudden unexpected death from primary posterior fossa tumors. Am J Forensic Med Pathol 1998, 19(:4): 303-8.
  • Abrahams NA, Prayson RA. The role of histopathologic examination of intracranial blood clots removed for hemorrhage of unknown etiology: a clinical pathologic analysis of 31 cases. Am Diagn Pathol 2000, 4(6): 361-6.

Year 2006, Volume: 20 Issue: 2, 79 - 84, 31.08.2006
https://izlik.org/JA69PE99GR

Abstract

References

  • Barker DJP, Weller RO, Garfield JS. Epidemiology of primary tumors of the brain and spinal cord: a regional survey in Southern England. J Neurol Neurosurg Psychiatry, 1976; 39: 290-296.
  • Nelson JS, Parisi JE, Schochet SS. Principles and practice of neuropathology. Mosby, 1993: 123-124.
  • Clark GB, Henry JM, McKeever PE. Cerebral pilocytic astrocytoma. Cancer, 1985; 56: 1128.
  • Garica DM et al. Astrocytomas of the cerebellum in children. J Neurosurg, 1989; 71: 661-64.
  • Byard RW, Bourne AJ, Hanieh A. Sudden and unexpected death due to hemorrhage from occult central nervous system lesions. A pediatric autopsy study. Pediatr Neurosurg, 1991-92; 17(2): 88-94.
  • Lo S, Kish KK. Juvenile Pilocytic Astrocytoma in http:// www.emedicine.com/radio/topic367.htm
  • Tomlinson FH. Atypia and malignancy in pilocytic astrocytoma of the cerebellum: a clinicopathologic and flow cytometric study. J Neuropathol Exp Neurol, 1992; 51: 331.
  • Havlik DM, Becher MW, Nolte KB. Sudden death due to primary diffuse leptomeningeal gliomatosis. J Forensic Sci, 2001; 46(2): 392-395.
  • DiMaio SM, Dimaio VJ, Kirkpatrick JB. Sudden, unexpected deaths due to primary intracranial neoplasms. Am J Forensic Med Pathol, 1980; 1(1): 29-45.
  • Ellison D, Love S, Chinnelli L, Harding BN, Lowe J, Vinters HV eds. Astrocytic Neoplasms. In Neuropathology, 2nd ed. London, Mosby; 2004: 623-640.
  • Robbins SL, Kumar V. Basic Pathology. WB Saunders CO, 1987: 741-744.
  • Mesiwala AH, Avellino AM, Roberts TS, Ellenbogen RG. Spontaneous cerebellar hemorrhage due to juvenile pilocytic astrocytoma: case report and review of the literature. Pediatr Neurosurg, 2001; 34(5): 235-8.
  • Gleckman AM, Smith TW. Sudden unexpected death from primary posterior fossa tumors. Am J Forensic Med Pathol 1998, 19(:4): 303-8.
  • Abrahams NA, Prayson RA. The role of histopathologic examination of intracranial blood clots removed for hemorrhage of unknown etiology: a clinical pathologic analysis of 31 cases. Am Diagn Pathol 2000, 4(6): 361-6.
There are 14 citations in total.

Details

Primary Language English
Subjects Forensic Biology
Journal Section Research Article
Authors

Yalçın Büyük This is me

Arzu T. Akçay This is me

Gülay Kurnaz This is me

İbrahim Üzün This is me

Submission Date January 1, 2006
Publication Date August 31, 2006
IZ https://izlik.org/JA69PE99GR
Published in Issue Year 2006 Volume: 20 Issue: 2

Cite

Vancouver 1.Yalçın Büyük, Arzu T. Akçay, Gülay Kurnaz, İbrahim Üzün. SUDDEN UNEXPECTED DEATH DUE TO CEREBELLAR ASTROCYTOMA (PILOCYTIC ASTROCYTOMA): AN AUTOPSY CASE*. J For Med [Internet]. 2006 Aug. 1;20(2):79-84. Available from: https://izlik.org/JA69PE99GR
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