Brain Tissue Pulmonary Embolism Due to Severe Blunt Force Head Trauma in a Dog

Pulmonary and Systemic Skeletal Muscle Embolism in a Beaked Whale with a Massive Trauma of Unknown Aetiology

Simple Summary

A severe trauma of unknown aetiology was suspected as the cause of death in an adult female Sowerby’s beaked whale found floating dead in the Canary Islands in December 2016. Many bruises in the skin and muscles (contusions) were observed in the chest wall and bone fractures, mainly located in the mandible and ribs. The broken rib bones also affected thoracic muscles, which escaped into the blood circulation once ruptured, reaching several organic locations, including the lungs, where they became trapped within the small lumen of pulmonary blood vessels, leading to a systemic and pulmonary skeletal muscle embolism. An embolism occurs when a piece of intravascular internal or foreign material obstructs the lumen of a blood vessel, starving tissues of blood and oxygen. An embolism necessarily needs cardiac function, indicating a survival time after trauma. This case report aimed to include the diagnosis of skeletal muscle embolism as a routine tool to determine if the traumatic event occurred before or after death. This is especially valuable when working with dead animals because no other evidence of traumatic injury may be recorded if carcasses are in advanced decay.

Abstract

An adult female Sowerby’s beaked whale was found floating dead in Hermigua (La Gomera, Canary Islands, Spain) on 7 December 2016. Severe traumas of unknown aetiology were attributed, and the gross and microscopic findings are consistent with catastrophic trauma as a cause of death. Rib fractures affected the intercostals, transverse thoracis skeletal muscles, and thoracic rete mirabile. Degenerated muscle fibres were extruded to flow into vascular and lymphatic vessels travelling to several anatomic locations into the thoracic cavity, including the lungs, where they occluded the small lumen of pulmonary microvasculature. A pulmonary and systemic skeletal muscle embolism was diagnosed, constituting the first description of this kind of embolism in an animal. The only previous description has been reported in a woman after peritoneal dialysis. Skeletal pulmonary embolism should be considered a valuable diagnostic for different types of trauma in vivo in wild animals. This is especially valuable when working with decomposed carcasses, as in those cases, it is not always feasible to assess other traumatic evidence.

Non-thrombotic pulmonary embolism of brain, liver, or bone marrow tissues associated with traumatic injuries in free-ranging neotropical primates

From 2016 to 2019, Southeastern Brazil faced an outbreak of yellow fever (YF) affecting both humans and New World primates (NWP). The outbreak was associated with a marked increase in traumatic lesions in NWP in the affected regions. Non-thrombotic pulmonary embolization (NTPE) can be a consequence of massive traumatic events, and it is rarely reported in human and veterinary medicine. Here, we describe NTPE of the brain, liver, and bone marrow in free-ranging NWP, highlighting the epidemiological aspects of these findings and the lesions associated with this condition, including data on traumatic injuries in wild NWP populations during the course of a recent YF outbreak. A total of 1078 NWP were necropsied from January 2017 to July 2019. Gross traumatic injuries were observed in 444 marmosets (44.3%), 10 howler monkeys (23.2%), 9 capuchins (31.0%), 1 titi-monkey (50.0%), and 1 golden lion tamarin (33.3%). NTPE was observed in 10 animals, including 9 marmosets (2.0%) and 1 howler monkey (10.0%). NTPE was identified in the lung and comprised hepatic tissue in 1 case, brain tissue in 1 case, and bone marrow tissue in 8 cases. Although uncommon, it is important to consider NTPE with pulmonary vascular occlusion during the critical care of traumatized NWP. In addition, this study highlights the importance of conservational strategies and environmental education focusing on One Health, not only to protect these free-ranging NWP populations but also to maintain the efficacy of epidemiological surveillance programs.