Ethanol distribution in the brain of a victim autopsied after acute subdural hemorrhage

We examined ethanol distribution in the brain of a 62-year-old male, who had died of acute subdural hemorrhage 4 days after injury. His blood ethanol concentration was 2.70 mg/g on admission. Blood pressure suddenly decreased and spontaneous respiration ceased 7 h after admission. He was artificially ventilated and died 4 days later. Ethanol was detected in the subdural hematoma, cerebellum, medulla oblongata and all cerebral lobes. Ethanol level in the right parietal lobe was highest; the levels in the right hemisphere of the cerebrum were higher than those in the left. Ethanol levels in the right parietal lobe were almost the same as the blood level calculated 7 h after admission; while the levels in the left parietal lobe and cerebellum were much lower. Thus, it was judged that cerebral blood flow first ceased in the right parietal lobe at 7 h after admission and completely ceased in other regions 11-12 h after. Assessment of ethanol distribution in multiple brain regions seems useful for estimating the time and progression profile of brain death.