Un caso letale di displasia fibromuscolare intracraniale con rottura di pseudo-aneurisma non diagnosticata: aspetti medico-legali

Cerebral vascular malformations, particularly those of middle cerebral artery (MCA), represent a rare case of sudden death. They generally remain unacknowledged until their rupture and show indicative signs and symptoms, especially of meningitis. The authors report a case concerning a young man with pseudo-aneurysm desiccation of the MCA within a fibromuscolar dysplasia. His condition was not diagnosed by the medical staff at the Emergency Room and resulted in his death. It appeared to be a profile of professional responsibility with regard to the physicians involved. Therefore, although this pathology is difficult to diagnose, it is to be considered within the range of diagnostic hypotheses when symptoms typical of ruprture are present. It is likewise fundamental to point out that this clinical scenario is not be neglected, whether in the E.R. or, especially, during autopsies on young persons who died suddenly.