BRAIN - Coning

The brain is mounted to display the cerebellar tonsils which have been compressed alongside the medulla and show a ring of compression corresponding to the foramen magnum. There is no bruising apparent.
This child had severe diffuse supravalvular aortic stenosis, associated with mild pulmonary stenosis affecting the right and left branches of the pulmonary artery together with mitral incompetence. Surgical repair was carried out but the child suffered a cardiac arrest towards the end of the procedure. At autopsy cerebral oedema was demonstrated.