Motor-vehicle collision-related death due to delayed-onset subarachnoid hemorrhage associated with anticoagulant therapy.

Delayed deaths following injury are not rare. Various mechanisms may be responsible for such deaths, including pulmonary thromboembolism, fat embolism, infection, systemic inflammatory response syndrome, and delayed hemorrhage. In the present case, we describe a death due to delayed subarachnoid hemorrhage following a motor vehicle collision, wherein the hemorrhage occurred ten days after the incident, while the patient remained hospitalized for skeletal trauma. At no time prior to the hemorrhage did the victim show any symptoms of brain injury. Autopsy revealed basilar subarachnoid hemorrhage arising from a cerebral cortical contusion. There was no evidence of aneurysm or arteriovenous malformation. A significant underlying contributing factor in the delayed hemorrhage was the victim's chronic anticoagulant therapy, which was required because of a mechanical heart valve.

Neurocysticercosis.

Neurocysticercosis results when the ingested eggs of the pork tapeworm, Taenia solium, hatch into larval forms that penetrate the gut wall, disseminate hematogenously, and then encyst in the brain. The subsequent symptoms and associated morbidity are variable. Worldwide, cysticercosis is the most common parasitic disease affecting the central nervous system, but it is not a common autopsy finding in the United States. Neurocysticercosis may be an incidental finding, a contributing cause of death, or the underlying cause of death. It is also important for the forensic pathologist to be aware of the possibility of neurocysticercosis in the autopsy population for purposes of epidemiology studies and infection control. The authors use cases of neurocysticercosis found at autopsy at their institution to give examples of each scenario and to review the clinical and pathologic features of this parasitic disease.