Brain autopsy

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Author: Mikael Häggström [notes 1]

Gross processing

Comprehensiveness

Factors supporting a relatively more comprehensive autopsy and/or report, particularly in the inclusion of negated findings:

  • Lack of explanation from existing evidence. On the other hand, for example, upon finding an obvious aortic rupture, the rest of the autopsy is less relevant and may be relatively short.
  • Double-reading: If your report is likely to undergo double reading by another pathologist before sign-out, it needs to be more detailed, because the doctor who will do the double-reading then knows that you have looked at those locations.
  • Highly suspected locations, such as given from the referral.

In this page, the following signs and text coloring are used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

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  • Inspect: Grooves indicating herniation? Hemorrhages?
  • Dissect the basilar artery and circle of Willis, either before or after separation from the brain.[notes 2] Look mainly for thromboses.
  • Separate the brainstem, cerebellum and cerebrum, which may be done by first separating the former two together from the cerebrum. Slice each part, looking for hemorrhages and/or infarcts.

Report

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The meninges and venous sinuses are unremarkable. ((The dura and venous sinuses are unremarkable. The leptomeninges are thin, shiny and non-irritated, with no visible bleeding.

(No visible thrombi. No subdural hematoma.)

The brain is symmetrical and weighs ___g. ( The cerebral and cerebellar hemispheres are of equal size, and have a normal weight of ___g. [[Men: 1.180 to 1.620 g. Women: 1.030 to 1.400 g]][1][2]
No signs of herniation (No grooves on the bases of the cerebrum or cerebellum.)

((The cerebral ventricles are of normal size, with normal linings.)) Cut surfaces of the cerebrum, cerebellum and brainstem show (normal gray and white parenchyma, and) no ((encephalomalacia, ))(hemorrhages, tumors or other) focal abnormalities.
The basal cerebral arteries << are ordinary / {{have mild / moderate / severe atherosclerosis}}>> without aneurysms or thrombus.

See also: General notes on reporting

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. The arteries of the skull base are preferably dissected after separation from the brain if there is a need to demonstrate the case.

References

  1. Standard reference range: Molina, D. Kimberley; DiMaio, Vincent J.M. (2012). "Normal Organ Weights in Men ". The American Journal of Forensic Medicine and Pathology 33 (4): 368–372. doi:10.1097/PAF.0b013e31823d29ad. ISSN 0195-7910. 
  2. Standard reference range: Molina, D. Kimberley; DiMaio, Vincent J. M. (2015). "Normal Organ Weights in Women ". The American Journal of Forensic Medicine and Pathology 36 (3): 182–187. doi:10.1097/PAF.0000000000000175. ISSN 0195-7910.