Selective postmortem arterial angiography of head and neck using digital x‐ray or computed tomography: A practical and rapid method to identify vascular injuries

Identification of vascular injuries is crucial for complete postmortem evaluation and understanding of trauma deaths by the Medical Examiner. Some vascular injuries are difficult to evaluate due to challenging anatomic locations, especially in the head and neck. Documenting injuries of the facial an...

Full description

Saved in:
Bibliographic Details
Published in:Journal of forensic sciences 2024-09, Vol.69 (5), p.1771-1781
Main Authors: Ali, Zabiullah, Mourtzinos, Nikki
Format: Article
Language:English
Subjects:
Angiography
autopsy
Barium
barium contrast media
carotid artery injury
Computed tomography
Digital imaging
Fatalities
Forensic pathology
forensic radiology
Head
Identification methods
indwelling Foley catheter
Injuries
Medical examiners
Medical imaging
postmortem angiography
postmortem arteriography
postmortem CT and digital radiography
selective postmortem CT and digital angiography
Tomography
vertebral artery injury
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Identification of vascular injuries is crucial for complete postmortem evaluation and understanding of trauma deaths by the Medical Examiner. Some vascular injuries are difficult to evaluate due to challenging anatomic locations, especially in the head and neck. Documenting injuries of the facial and vertebral arteries is challenging and necessitates time‐consuming dissections that can create artifacts and disfigurement. In busy medical examiner offices with a significant number of traumatic injuries, finding a creative solution to employ reliable postmortem angiography is desirable. At the Office of the Chief Medical Examiner for the State of Maryland (OCME), we created and effectively implemented a selective angiography procedure using traditional indwelling Foley catheters and water‐soluble barium swallow contrast to evaluate arterial injuries using either digital radiography or computed tomography imaging modalities. This technique and imaging interpretation can be performed by a medical examiner or forensic pathology fellow after basic technical training and basic radiology training. This study outlines the technique, methods, and utilization of the procedure and describes the findings of six deaths due to vascular lesions from different injury mechanisms and disease processes and describes the ease of implementation on a broader scale in busy Medical Examiner's offices.
ISSN:0022-1198
1556-4029
1556-4029
DOI:10.1111/1556-4029.15568