The forensic and clinicopathological spectrum of the vertebral artery
Bibliographic record
Abstract
We report the forensic and clinicopathological spectrum of 14 postmortem cases involving the vertebral artery. In all cases, there was either pontocerebellar infarction (n = 8) or subarachnoid hemorrhage (n = 6). The underlying pathology of the vertebral artery was segmental mediolytic arteriopathy (n = 5), traumatic rupture of the arterial wall (n = 3), arterial dissection (n = 2), or atherosclerosis (n = 4). Histopathologic changes were often present in both the intracranial and extracranial segments of the vertebral artery. In our case series, the most frequent disease in the vertebral artery was segmental mediolytic arteriopathy which sometimes simultaneously involved the superior mesenteric artery. Our data show that a heterogeneous combination of acquired and genetic cofactors likely played a role in etiopathogenesis. The two main cofactors included sudden neck movements from applied external force (7/14 case, 50 %), and genetics (3/14 case, 21 %). Mutations in structural or regulatory genes of the arterial wall appear to be key risk factors and may interact with trauma or neck motion to result in fatal outcomes. We recommend that the autopsy of all cases with suspected vertebral artery lesions include histologic examination of both the intracranial and extracranial segments of the vertebral artery, histologic sampling of the intra-abdominal (mesenteric) arteries, and genetic testing. This will help clarify the role of injury, genetics, and disease when determining the cause of death in these complex cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.005 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".