Cardiac arrest after traffic accident induced through vagal reflex in a case with bilateral stenosis of vertebral arteries

An 84-year-old driver suffered cardiac arrest after a traffic accident. He was quickly resuscitated and transferred to a hospital where he was treated in a state of unconsciousness and respiratory failure for 20 days until his death. The brain stem was rendered anoxic during cardiac arrest, which ca...

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Bibliographic Details
Published in:Forensic science international 1995-03, Vol.72 (2), p.117-123
Main Authors: Yoshida, Ken-ichi, Harada, Kazuki, Makisumi, Toshirou, Sorimachi, Yoshihide, Tateishi, Akio, Ishihara, Tokuhiro, Maekawa, Tsuyoshi
Format: Article
Language:English
Subjects:
Accidents, Traffic
Aged
Aged, 80 and over
Autopsy
Biological and medical sciences
Heart Arrest - etiology
Humans
Male
Medical sciences
Nervous system involvement in other diseases. Miscellaneous
Neurology
Posture - physiology
Reflex - physiology
Stenosis of vertebral arteries
Sudden cardiac arrest
Traffic accident
Vagal reflex
Vagus Nerve - physiology
Vertebral Artery - physiology
Vertebrobasilar Insufficiency - complications
Vertebrobasilar Insufficiency - physiopathology
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Summary:An 84-year-old driver suffered cardiac arrest after a traffic accident. He was quickly resuscitated and transferred to a hospital where he was treated in a state of unconsciousness and respiratory failure for 20 days until his death. The brain stem was rendered anoxic during cardiac arrest, which caused the respiratory failure. Artificial ventilation and catecholamine infusion were carried out, resulting in myocardial degeneration. Bilateral stenosis of the vertebral arteries was disclosed, but no injuries or hemorrhage of the brain and spinal cord were detected. On days 3 and 4 after admission, immediately after the head of the victim was flexed forward for examinations, cardiac arrest was induced twice, but was controlled either by administering atropine or by restoring the original posture. Positional change is known to induce vagal reflex that results in bradycardia, hypotension or cardiac arrest in sensitive persons. The victim might have undergone the reflex-mediated cardiac arrest after the accident, to which the stenosis of the vertebral arteries may have contributed.
ISSN:0379-0738
1872-6283
DOI:10.1016/0379-0738(94)01690-7