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Autopsy and Medicine
November 8, 1999

Case of the Month: The Autopsy and the Living

Kim A. Collins, MD; Allan T. Bennett, MD; Randy Hanzlick, MD; et al and the Autopsy Committee of the College of American Pathologists
Arch Intern Med. 1999;159(20):2391-2392. doi:10.1001/archinte.159.20.2391

A 62-YEAR-OLD white woman was found dead in her bed one morning. She had gone to bed the night before complaining of a headache. Her medical history included hypertension, mild obesity, and recent headaches; otherwise, her health had been good. A complete autopsy was requested by her family and physician.

The autopsy showed diffuse subarachnoid hemorrhage caused by a ruptured berry aneurysm of the middle cerebral artery. Her heart weight was increased to 500 g, the left ventricular wall thickness was increased to 2.0 cm, and both kidneys showed granular surfaces consistent with nephrosclerosis. Microscopic examination of sections of the heart showed hypertrophic myocytes and enlarged barrel-shaped nuclei; the kidneys showed scarred glomerular tufts typical of nephrosclerosis. All of these findings are typical in patients with a history of hypertension.

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