A RETROSPECTIVE AND PROSPECTIVE-STUDY OF CEREBRAL TISSUE PULMONARY-EMBOLISM IN SEVERE HEAD TRAUMA

In an attempt to determine the incidence of pulmonary embolization of cerebral tissue as the result of severe head trauma with and without d ural penetration, we have collected the autopsy reports at our institu tion of all head injury victims over the past 3.5 years. The retrospec tive and prospective histologic examination of these cases revealed a total of 10% to have emboli of cerebral tissue within the pulmonary va sculature. Immunohistochemical staining of the emboli confirmed the ne ural origin of the tissue. The dura mater proved to be intact in 70% o f the cases of cerebral embolization. We feel this provides evidence t hat embolization of cerebral tissue may occur without rupture of the d ura and/or large venous sinuses. This observation is of clinical as we ll as forensic importance, as cerebral tissue emboli are a rich source of thromboplastin in the systemic and pulmonary vasculature and may c ontribute to the morbidity and mortality of head injuries.