Forensic Pathology for Police - Brainshare Public Online Library

228 10 Natural Deaths
Fig. 10.16 Thebaseofa
brain showing basilar
subarachnoid hemorrhage.
When this is discovered at
autopsy, the pathologist must
carefully search for a ruptured
berry aneurysm. This involves
attempting to wash away
much of the hemorrhage
while maintaining the
integrity of the blood vessels
Fig. 10.17 A close-up view of the base of the brain in Fig. 10.16, after washing away much of the
subarachnoid hemorrhage. Note the presence of a berry aneurysm (arrows)
can spontaneously rupture. Underlying hypertension may or may not be present.
Usually, the AVMs will be evident grossly (Disc Image 10.36), but some examples
are quite small. Microscopic identification of multiple vessels allows a diagnosis to
be given (Disc Image 10.37).
Dural Sinus Thrombosis
Thrombus (blood clot) formation within the veins of the dura mater (the “dural
sinuses”) is a relatively rare condition that can cause central nervous system symptoms
(such as headaches), “strokes,” and even sudden death. The condition is more