An autopsy case of traumatic middle cerebral artery occlusion

An autopsy case of middle cerebral artery occlusion following closed head injury is reported. A 16-year-old laborer received head injuries in a motorcycle-automobile accident. On first examination at the time of admission, semi-coma, left-sided hemiplegia and other focal cerebral signs were evident. Roentgenographic examination revealed fractures of the skull. A CT scan of the head 24 h after injury revealed a massive right-sided cerebral infarct with midline shift. On the 4th day, angiography showed tapering occlusion of the right internal carotid artery at the top of the 3rd cervical vertebra. The patient died from the cerebral infarct 7 days after injury. At autopsy, thrombotic obstruction at the origin of the right middle cerebral artery due to a dissecting aneurysm was found.