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Three Unusual Neuropathologic-Related Causes of Sudden Death

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We discuss the autopsy findings of three medico-legal cases of sudden death associated with uncommon neuropathologic findings of which the general forensic pathologist may not be familiar. Case 1 was a 43-year-old man who died of a seizure due to malignant melanoma of the temporal lobe associated with neurocutaneous melanosis (NCM). Case 2 was a 57-year-old woman with a history of mental retardation and incoordination because of chronic lead poisoning, who died of a pulmonary thromboembolism due to deep venous thrombosis status post left leg fracture after a fall down a staircase. Autopsy revealed atrophy and gliosis of her cerebellum as a result of childhood lead poisoning. The third patient was a 75-year-old woman who died as a result of acute bacterial leptomeningitis at the cervico-medullary junction with acute inflammation of the connective tissue of her upper cervical spinal column associated with subluxation of her atlantoaxial (AA) joint, also known as Grisel’s syndrome.
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Keywords: Grisel’s syndrome; forensic science; lead encephalopathy; neurocutaneous melanosis; neuropathology; sudden death

Document Type: Research Article

Affiliations: Dutchess County Medical Examiner’s Office, 387 Main Street, Poughkeepsie, NY 12601.

Publication date: 01 May 2008

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