Summary
Autopsies on 195 male alcoholics aged 30–64 years who died outside hospitals and nursing homes in Oslo from 1984 to 1988, were carried out at the Institute of Forensic Medicine, Rikshospitalet. In 127 cases brain tissue was examined neuropathologically, 86 (67.7%) showed abnormalities and 28 contained lesions of more than one type. Lesions associated with alcoholism were found in 61 cases (48%), 18 (14.2%) showed Wernicke's encephalopathy, 47 (37%) cerebellar atrophy, 2 central pontine myelinolysis and 1 hepatic encephalopathy. Subdural haematoma and/or cortical contusions were found in 30 cases (23.6%) and cerebrovascular lesions in 19 (15%). Of the 195 cases, 22 had a history of recurrent convulsive attacks of which 19 were examined neuropathologically and 13 had focal damage that could have caused epileptic fits. Although cerebral damage was more frequent among vagrants and other persons dependant on social support, 50% of the alcoholics living in their own homes were also affected. Alcohol-related disease was considered the cause of death in 15 of 127 cases examined neuropathologically and 9 of these died from acute Wernicke's encephalopathy all of whom were sober at death. Although the post mortem analyses included neuropathological examination of the brain, the cause of death remained unknown in 27 (21%) of the 127 cases.
Zusammenfassung
Obduktionen an 195 männlichen Alkoholikern, welche im Lebensalter zwischen 30 und 64 Jahren in den Jahren 1984–1988 verstarben, wurden am Institut für Gerichtliche Medizin des Rikshospitalet in Oslo durchgeführt. Die Personen starben außerhalb von Krankenhäusern und von Pflegeheimen. In 127 Fällen wurde Hirngewebe neuropathologisch untersucht. 86 Fälle (67,7%) zeigten abnorme Befunde und 28 Fälle zeigten Läsionen von mehr als einem Typ. Alkohol assoziierte Läsionen wurden in 61 Fällen gefunden (48%); 18 (14,2%) zeigten die Wernicke'sche Encephalopathie, 47 (37%) eine cerebellare Atrophie, 2 eine zentrale pontine Myelinolyse und einer eine hepatogene Encephalopathie. Subdurale Hämatome und/oder Rindenprellungen wurden in 30 Fällen (23,6%) gefunden und cerebro-vasukläre Läsionen in 19 Fällen (15%). 22 der insgesamt 195 Fälle zeigten in ihrer Vorgeschichte wiederholte Anfälle. 19 hiervon wurden neuropathologisch untersucht und 13 hatten fokale Schäden, die die epiletpischen Anfälle verursacht haben konnten. Obwohl der Hirnschaden häufiger unter Obdachlosen und anderen Personen, welche von einer Sozialhilfe abhänging sind, war, waren 50% der Alkoholiker, welche in ihren eigenen Häusern lebten, ebenfalls befallen. In 15 der 127 neuropathologisch untersuchten Fälle wurde die alkoholinduzierte Erkrankung als Todesursache angesehen. 9 dieser Fälle verstarben an einer akuten Wernicke-Encephalopathie, alle waren nüchtern zum Zeitpunkt des Todes. Obwohl die postmortalen Untersuchungen eine neuropathologische Untersuchung des Hirns einbezog, blieb die Todesursache in 27 von 127 Fällen (= 21%) unbekannt.
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Skullerud, K., Andersen, S.N. & Lundevall, J. Cerebral lesions and causes of death in male alcoholics. Int J Leg Med 104, 209–213 (1991). https://doi.org/10.1007/BF01369809
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DOI: https://doi.org/10.1007/BF01369809
Key words
- Alcoholism
- Alcoholic cerebellar atrophy
- Wernicke's encephalopathy
- Central pontine myelinolysis
- Traumatic lesions
- Cerebrovascular lesions