Simon’s sign: Case report and review of the literature

2021 ◽  
pp. 002581722110062
Author(s):  
Michel Tawil ◽  
Serenella Serinelli ◽  
Lorenzo Gitto

Hanging is a common method of suicide and multiple autopsy findings can be observed at the postmortem examination. Simon's sign is a haemorrhage into the anterior aspect of the intervertebral discs of the lumbar region that can be observed in hangings and other traumatic causes of death. This finding is considered evidence of vitality. Several mechanisms have been proposed regarding bleeding development. In this paper, we present a case of hanging in which Simon's sign was observed at the autopsy. A review of the literature regarding Simon's bleeding has been performed, and a discussion of the potential mechanism is reported. Although Simon's sign may be observed in hangings, a careful evaluation of all the available data, including investigation, autopsy findings, and toxicology, is mandatory to avoid misinterpretation of death's cause and manner.

2014 ◽  
Vol 8 (4) ◽  
pp. 1625-1627
Author(s):  
XUE-LI YANG ◽  
SAN-JUN LU ◽  
JIE XUE ◽  
YAN-FEN WU ◽  
JUN-LING SHI

2005 ◽  
Vol 91 (1) ◽  
pp. 90-92 ◽  
Author(s):  
Roberto Buzzoni ◽  
Silvia Della Torre ◽  
Diego Cortinovis ◽  
Laura Catena

Synchronous multicentric osteosarcoma is a rare entity with fewer than 100 well documented cases in the medical literature. The disease usually progresses rapidly in young patients and slightly slower in adults. We present a case of synchronous multicentric osteosarcoma with some peculiarities in a 73-year-old woman. The diagnosis was made after postmortem examination, which underlines the importance of this procedure. This case report is accompanied by a review of the literature.


1996 ◽  
Vol 09 (04) ◽  
pp. 177-178 ◽  
Author(s):  
R. Selcer ◽  
W. H. Adams ◽  
W. B. Thomas ◽  
B. E. Wilkens

SummaryThree middle-aged (6-8 years), intact male Dachshunds were admitted to the University of Tennessee Veterinary Teaching Hospital (UTVTH) with acute onset of back pain and pelvic limb paralysis.Physical examination of dog #1 revealed hyperaesthesia of the thoracolumbar spine. Superficial pain sensation was absent in the pelvic limbs, while deep pain sensation was intact. The cutaneous trunci (panniculus) reflex was absent caudal to the thoraco-lumbar region. Reflexes to the pelvic limbs were exaggerated.A myelogram showed dorsal deviation of the ventral contrast column and attenuation of the ventral and dorsal contrast columns at the T9-T10 disc space. A hemilaminectomy was performed from T9 to T10, and mineralized disc material was retrieved from the vertebral canal at T9-T10. The T9- T10 to L3-L4 disc spaces were fenestrated. Two weeks after surgery, superficial and deep pain sensation of the rearlimbs were present, but paralysis persisted. The animal was euthanatised at the owners’ request. A postmortem examination was not performed.Dog #2 displayed absent superficial pain sensation, and intact deep pain sensation of the pelvic limbs. Hyperaesthesia of the thoracolumbar region and hyperreflexia of the rear limbs were noted. Examination of the cutaneous trunci reflex was not performed. A myelogram revealed ventral extradural compression of the spinal cord at T9- T10. A T9-T10 hemilaminectomy revealed a large amount of extruded disc material, which was removed. The Tll- T12 to L4-L5 intervertebral discs were fenestrated. Forty-eight hours postoperatively, the patient regained voluntary motor function, and recovery was uneventful.Neurologic examination of dog #3 revealed absence of deep pain sensation in the pelvic limbs; duration of which was not known. Spinal radiographs and myelography revealed ventral extradural spinal cord compression at T9-T10 (Fig.). A right-sided hemilaminectomy at T9-T10 revealed a large amount of calcified disc material, ventral to the spinal cord. The T11-T12 through Ll- L2 intervertebral discs were fenestrated. Sixty days postoperatively, paralysis persisted and the dog was euthanatised. No postmortem examination was performed.Herniation of the T9-T10 intervertebral disc was diagnosed in three Dachshunds with acute paraplegia. The clinical diagnosis and surgical management of T9-T10 disc herniation are similar to that in the more common sites of disc herniation.


2014 ◽  
Vol 37 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Philippa Sexton ◽  
Joseph T. Thomas ◽  
Scott Petersen ◽  
Nicole Brown ◽  
Jane E. Arms ◽  
...  

Penoscrotal transposition is a rare congenital abnormality. We report a case presenting prenatally with ambiguous genitalia and renal anomaly on obstetric ultrasound and fetal MRI and discuss the postnatal examination and autopsy findings. We present a review of the literature, including associated gene abnormalities.


1994 ◽  
Vol 108 (2) ◽  
pp. 178-180 ◽  
Author(s):  
Ewan K. A. Millar ◽  
Richard Vaughan Jones ◽  
Stephen Lang

AbstractA case of prostatic adenocarcinoma presenting with dysphagia due to a tonsillar metastasis is described. Details of the clinical history, histopathological and autopsy findings are presented. A review of the literature suggests that this is only the second description of such an occurrence.


2011 ◽  
Vol 155 (12) ◽  
pp. 3007-3024 ◽  
Author(s):  
Samantha A. Schrier ◽  
Ilana Sherer ◽  
Matthew A. Deardorff ◽  
Dinah Clark ◽  
Lynn Audette ◽  
...  

1996 ◽  
Vol 26 (3) ◽  
pp. 319-328 ◽  
Author(s):  
Manuel F. Casanova

Objectives: A review of the neuropathology literature in schizophrenia suggests that some patients with this disease exhibit periventricular gliosis at postmortem examination. Several researchers have speculated that this finding is the remnant of either a prior viral infection or a gestational intraventricular hemorrhage. The present article uses a case report to hypothesize and discuss an alternate possibility to the putative gliosis, namely Wernicke's disease. Method: Based on the pathological findings of our patient and a review of the literature, the author summarizes several reasons why Wernicke's disease may occur, and still be unnoticed, in some schizophrenic patients. Results: Inefficient self-care and homelessness predisposes some patients with schizophrenia to poor dietary habits and malnutrition. Similarly, the high prevalence of concurrent alcoholism in patients with schizophrenia may propitiate thiamine deficiency. The resulting brain insult may be compounded by disturbances of carbohydrate metabolism which may be peculiar to the schizophrenic process itself, or acquired, as in coincidental diabetes. Conclusions: Since symptoms accrued to Wernicke's may often be subtle and obscured by other schizophreniform manifestations, clinicians should lower their threshold for suspecting this potentially fatal complication. The diagnostic possibility of Wernicke's should be especially entertained in schizophrenic patients who are alcoholics and/or diabetics.


2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Hiroki Tashiro ◽  
Koichiro Takahashi ◽  
Hironori Sadamatsu ◽  
Masaru Uchida ◽  
Shinya Kimura ◽  
...  

Diffuse alveolar haemorrhage (DAH) is one of the major causes of death in microscopic polyangiitis (MPA) patients, because of acute respiratory failure with various respiratory symptoms. We, herein, present a case of chronic and asymptomatic DAH in a patient with MPA who was diagnosed by fibreoptic bronchoscopy. The patient showed localized reticular shadows, without any respiratory symptoms, and absence of inflammatory reactions, such as fever and CRP elevation, which is atypical for DAH. Three months after appearance of the lung abnormalities, DAH with MPA was diagnosed by fibreoptic bronchoscopy. She was initially treated with only corticosteroids and has thereafter been maintained with corticosteroids and azathioprine without relapse to date. We reviewed the literature for similar cases and opined that physicians should perform fibreoptic bronchoscopy in MPA patients with chronic lung abnormalities and anaemia to identify DAH, even if the patients show no respiratory symptoms and in the absence of inflammatory reactions.


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