Macroscopic and histological examination of human bridging veins.

In infantile abusive head injury (AHT), subdural haemorrhage (SDH) is commonly held to result from traumatic damage to bridging veins traversing from the surface of the brain to the dura and dural venous sinuses. However, there are limited published radiological or autopsy demonstrations of ruptured bridging veins and several authors also assert that bridging veins are too large to rupture due to the forces associated with AHT. There have been several studies on the size, locations and numbers of adult bridging veins and there is one small study of infant bridging veins.

A systematic autopsy survey of human infant bridging veins.

In the first years of life, subdural haemorrhage (SDH) within the cranial cavity can occur through accidental and non-accidental mechanisms as well as from birth-related injury. This type of bleeding is the most common finding in victims of abusive head trauma (AHT). Historically, the most frequent cause of SDHs in infancy is suggested to be traumatic damage to bridging veins traversing from the brain to the dural membrane.

Could post-mortem computed tomography angiography inform cardiopulmonary resuscitation research?

Aim: Firstly, to develop an optimised chest compression post mortem computed tomography angiography protocol in the adult human during closed chest compression to investigate cardiopulmonary resuscitation blood flow, and secondly to provide preliminary observations of post-mortem anatomical cardiac chamber movement using a novel radiolucent static chest compression device.

Methods: Variable volumes of radiological contrast agent were injected intravenously into a series of consented human cadavers. Each cadaver had chest compressions delivered with a LUCAS™2 mechanical chest compressor.

Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study.

Background: England and Wales have one of the highest frequencies of autopsy in the world. Implementation of post-mortem CT (PMCT), enhanced with targeted coronary angiography (PMCTA), in adults to avoid invasive autopsy would have cultural, religious, and potential economic benefits. We aimed to assess the diagnostic accuracy of PMCTA as a first-line technique in post-mortem investigations.

Post-mortem computed tomography coaxial cutting needle biopsy to facilitate the detection of bacterioplankton using PCR probes as a diagnostic indicator for drowning.

We report for the first time the use of coaxial cutting needle biopsy, guided by post-mortem computed tomography (PMCT), to sample internal body tissues for bacterioplankton PCR analysis to investigate drowning. This technical report describes the biopsy technique, the comparison of the needle biopsy and the invasive autopsy sampling results, as well as the PMCT and autopsy findings. By using this new biopsy sampling approach for bacterioplankton PCR, we have developed on previous papers describing the minimally invasive PMCT approach for the diagnosis of drowning.

Ventilated post-mortem computed tomography through the use of a definitive airway.

Ventilated post-mortem computed tomography (VPMCT) has been shown to achieve lung expansion in cadavers and has been proposed to enhance the diagnosis of lung pathology. Two key problems of the method of ventilation have been identified: firstly, the presence of head and neck rigor making airway insertion challenging and, secondly, air leak, if there is not a good seal around the airway, which diminishes lung expansion and causes inflation of the stomach. Simple procedures to insert a 'definitive' cuffed airway, which has a balloon inflated within the trachea, are therefore desirable.

The effect on cadaver blood DNA identification by the use of targeted and whole body post-mortem computed tomography angiography.

Post-mortem computed tomography angiography (PMCTA) involves the injection of contrast agents. This could have both a dilution effect on biological fluid samples and could affect subsequent post-contrast analytical laboratory processes. We undertook a small sample study of 10 targeted and 10 whole body PMCTA cases to consider whether or not these two methods of PMCTA could affect post-PMCTA cadaver blood based DNA identification.

Pump injector system applied to targeted post-mortem coronary artery angiography.

Targeted post-mortem computed tomography angiography (PMCTA) is one of several methods described that can be used to investigate the coronary arteries after death. Previously, this particular method has involved the manual injection of contrast media. However, manual systems do not mimic physiological conditions (arterial pressure) and may not provide optimal contrast, as iodinated contrast medium dissipates rapidly from the intra- to the extra-vascular space.

Consent of the recently bereaved to post-mortem targeted angiography research: 207 adult cases.

Aims: To present our experience of prospective telephone consenting for post-mortem CT angiography (PMCT-A) research using HM coroners' cases.

Methods: Local ethics committee, research and development office, and local HM coroners gave their permission for the families of the deceased, in cases where a 'routine' coroner's autopsy had been authorised, to be approached for their consent to PMCT-A research before the autopsy examination. A forensic pathologist or trial consenter telephoned the next of kin, discussed the nature of the study and obtained verbal informed consent for post-mortem imaging, angiography, case-dependent histological and toxicology sampling and for the use of the images for teaching and training.