Aneurysm as a cause of death and post mortem

Shivendra Pratap Singh


High Court Lucknow

Medico Legal

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Published on: 12 Aug, 2023

An aneurysm is a potentially fatal medical condition. If an aneurysm ruptures, it can lead to internal bleeding and possibly death. When an individual dies unexpectedly and an aneurysm is suspected as the cause of death, a post-mortem examination (autopsy) is often performed to confirm the diagnosis and gather more information about the event.

Aneurysm as a Cause of Death:

  1. Rupture and Internal Bleeding: The main danger of an aneurysm is its potential to rupture. When this happens, blood escapes from the vessel and can cause significant internal bleeding. Depending on the location of the aneurysm, this bleeding can lead to stroke, organ failure, or other catastrophic outcomes.
  2. Types and Locations: While aneurysms can form in any blood vessel, those in the aorta (aortic aneurysms) and the brain (cerebral aneurysms) are most concerning in terms of rupture and life-threatening outcomes.
  3. Signs of Rupture: These vary based on the location of the aneurysm.
    • A ruptured cerebral aneurysm often presents as a sudden and severe headache, sometimes described as the “worst headache of one’s life.”
    • A ruptured aortic aneurysm might cause intense pain in the abdomen or back, dizziness, nausea, and signs of shock like rapid heart rate and low blood pressure.

Post-mortem Examination (Autopsy) for Aneurysm:

When an aneurysm is suspected to be the cause of death, a post-mortem examination provides crucial insights:

  1. External Examination: The body is first inspected for any external signs of trauma or medical interventions.
  2. Internal Examination: This is where evidence of an aneurysm would be located. The pathologist will inspect the major blood vessels, especially the aorta and the vessels in the brain, for any bulging or ruptured areas.
  3. Cause and Mechanism of Death: The pathologist will determine the direct cause of death (e.g., rupture of an aortic aneurysm leading to massive internal bleeding) and possibly the mechanism or the sequence of events that led to the death (e.g., rupture leading to rapid blood loss, drop in blood pressure, and cardiac arrest).
  4. Histological Examination: Tissue samples may be taken from the aneurysm site and viewed under a microscope. This can provide more details about the aneurysm’s characteristics, such as its size, wall thickness, and any signs of inflammation.
  5. Toxicology Testing: Although not directly related to the aneurysm, a standard part of many autopsies is toxicology testing. This determines if there were any substances in the deceased’s system that might have contributed to the aneurysm or rupture.
  6. Report: After all examinations are concluded, a detailed report is compiled to provide answers to the cause and manner of death. This report can be vital for both medical and legal purposes.


Aneurysms are silent threats that, when they rupture, can lead to sudden and tragic outcomes. A thorough post-mortem examination is essential to confirm the cause of death and provide clarity for both the medical community and grieving families. If there’s a family history of aneurysms or known risk factors, regular medical check-ups are vital for early detection and intervention.


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