Cerebral hemorrhage, secondary to acute myeloid leukemia - Erler Zimmer 3D anatomy Series MP2009

This dissection model highlighting a Cerebral Hemorrhage, Secondary to Acute Myeloid Leukemia is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical history

A 22-year-old man presented with a 2-week history of generalized malaise, weight loss and bruised skin without any trauma. He recently developed 5 days of productive cough and fevers. He was admitted to the hospital for further investigation but had a sudden loss of consciousness and died a few minutes after admission to the hospital.

Pathology

The specimen is a horizontal slice of brain showing the upper surface of the cut. In the right frontal and parietal region are two large intraparenchymal hemorrhages each with a maximum diameter of 5 cm. Several smaller hemorrhages are present in the white matter of both hemispheres. This is an example of multiple intraparenchymal brain hemorrhages in a patient with acute myeloid leukemia (AML).

Additional Information.

Intraparenchymal cerebral hemorrhages are the result of small broken vessels within the brain causing hemorrhage. They are usually associated with sudden onset neurological symptoms. The most common causes of spontaneous (nontraumatic) intraparenchymal hemorrhages are hypertension and cerebral amyloid angiopathy with a peak incidence in the 6th decade of life.

AML is a tumor of hematopoietic progenitors that causes bone marrow failure due to immature accumulation of blasts in the marrow. Immature blasts affect the production of other bone marrow-derived cells leading to bone marrow failure by causing anemia (reduced erythrocytes), thrombocytopenia (reduced platelet production and bleeding tendency), and neutropenia (reduced neutrophil production). These in turn lead to a wide spectrum of disease complications, which must be anticipated and managed. Infection is the leading cause of death in AML due to neutropenia. Intracranial hemorrhage is the second most common cause of death in AML, due to low or dysfunctional platelets caused by thrombocytopenia. A severe form of hemorrhage is called disseminated intravascular coagulation (DIC) and is common in acute myeloid leukemia. DIC is characterized by small blood clots that develop throughout the bloodstream, blocking capillaries. Increased clotting depletes platelets and clotting factors needed to control bleeding, causing excessive bleeding.

Symptoms depend on the location and severity of the bleeding. Interventions include surgical evacuation of the hematoma, reversal of the coagulopathy, treatment of any seizures, and adjustment of intracranial pressure. Interventions depend on the severity of bleeding and the clinical setting. The 30-day mortality for intracerebral hemorrhage ranges from 35 to 50 percent with most deaths occurring in the first 48 hours.

What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.