K. Yoshida et al., CARDIAC-ARREST AFTER TRAFFIC ACCIDENT INDUCED THROUGH VAGAL REFLEX INA CASE WITH BILATERAL STENOSIS OF VERTEBRAL ARTERIES, Forensic science international, 72(2), 1995, pp. 117-123
An 84-year-old driver suffered cardiac arrest after a traffic accident
. He was quickly resuscitated and transferred to a hospital where he w
as treated in a state of unconsciousness and respiratory failure for 2
0 days until his death. The brain stem was rendered anoxic during card
iac arrest, which caused the respiratory failure, Artificial ventilati
on and catecholamine infusion were carried out, resulting in myocardia
l degeneration, Bilateral stenosis of the vertebral arteries was discl
osed, but no injuries or hemorrhage of the brain and spinal cord were
detected. On days 3 and 4 after admission, immediately after the head
of the victim was flexed forward for examinations, cardiac arrest was
induced twice, but was controlled either by administering atropine or
by restoring the original posture. Positional change is known to induc
e vagal reflex that results in bradycardia, hypotension or cardiac arr
est in sensitive persons. The victim might have undergone the reflex-m
ediated cardiac arrest after the accident, to which the stenosis of th
e vertebral arteries may have contributed.