Article Figures & Data
Figures
- Fig 1.
The “lumpy” falx. Axial noncontrast CT image demonstrates irregularity along the falx (arrows). This is related to high attenuation within the venous structures and not subarachnoid hemorrhage. More peripherally located venous structures also demonstrate high attenuation (arrowhead)
- Fig 2.
Increased vascular attenuation. A, Sagittal reformation from a noncontrast CT reveals high attenuation within the sagittal (arrow) and straight sinuses (arrowhead). The irregular appearance of the sagittal sinus is related to the cortical veins draining into the sinus. B, Axial noncontrast CT through the level of the circle of Willis reveals increased attenuation within the arteries. The beam-hardening artifact is related to the grommets on the human remains pouch.
- Fig 3.
Visualization of the basal ganglia. Axial CT using narrow window and level (50W 35 L) allows for visualization of both the basal ganglia and thalami.
- Fig 4.
Bilateral subdural hemorrhage not seen on CT. A, Photograph from autopsy in which the left aspect of the dura has been reflected to the right, revealing the left-sided subdural hematoma that is adherent to the dura. Note that viewing the brain from above changes right–left orientation from the convention used on CT. B, Noncontrast CT coronal reformat from the same subject does not demonstrate subdural hemorrhage. No evidence of hemorrhage was seen on the original axial images or the sagittal reformation.
- Fig 5.
Cerebral autolysis. Noncontrast CT reveals low cerebral attenuation, with loss of the gray–white differentiation, and sulcal and cisternal effacement.
- Fig 6.
Hematocrit effect. A, Axial noncontrast CT reveals high attenuation within the posterior aspect of the sagittal sinus but low attenuation within the anterior aspect of the sinus (arrow). Beam-hardening artifact is caused by the grommets on the body bag. B, Sagittal reformation demonstrates the fluid–fluid level in the sagittal sinus (arrow).
- Fig 7.
Hyperattenuating vein. Axial (A) and coronal reformat (B) noncontrast CT demonstrates a hyperattenuating vein in the left tempoparietal region (arrows). This should not be mistaken for subarachnoid hemorrhage.
- Fig 8.
Vascular air. Axial noncontrast CT images demonstrate air within both the arterial and venous structures, which is relatively symmetrically distributed. In addition, air is seen within the subcutaneous tissues (arrows).
Tables
Postmortem Imaging Findings
Case Type Loss of G–W Differentiation Effaced Ventricles/Cisterns Expected PM Blood Distribution PM Intracranial Air Lumpy Falx Trauma Visible BG 22/24 Yes 15/24 Yes 19/24 12/24 12/24 Loss of G–W 7/24 Normal 8/24 SAH 4/24 Dilated 1/24 Natural cause of death Visible BG 8/9 Yes 4/9 Yes 8/9 2/9 8/9 Loss of G–W 7/9 Normal 5/9 -
Note:—Loss of G–W differentiation evaluated by whether BG visible and whether remaining G–W visible. Expected PM blood distribution = dense circle of Willis, cavernous sinus, tentorium, transverse sinus, sagittal sinus. PM Intracranial Air = air in the arteries, veins, or diploic spaces. Lumpy Falx = nodular appearance to falx seen in PM imaging. BG indicates basal ganglia; G–W, gray–white; PM, postmortem.
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