Forensic implications of giant aneurysms: two autopsy cases

The neuropathological features seen in two cases with giant intracerebral aneurysm (GIA) and their forensic implications are presented. A 60-year-old woman fell while riding her bicycle and broke her femur. After a month she died suddenly while having lunch in the rehabilitation center. A 42-year-old woman with recent behavioral disorders and depression died suddenly at home by unknown causes. Upon autopsy, both cases had a GIA with rupture and recent bleeding. GIAs in both cases progressed slowly and were only detected by post-mortem examination. GIAs have several forensic implications. They can mimic brain tumors, cause sudden unexpected death, and alter patients’ behavior. The fact that GIAs can mimic brain tumors should lead to clinical and radiological monitoring of symptomatic cases. In the forensic field, knowing the natural history of GIA is of fundamental importance for clarifying the cause and manner of death.