Ahrendsen and Varma reported causes of greenish discoloration of the brain at autopsy. The authors are from Beth Israel Deaconess Medical Center and Harvard Medical School.
Patient selection: focal or diffuse greenish colored brain at autopsy
Causes of a greenish discoloration of the brain at autopsy:
(1) intravenous injection of methylene blue
(2) severe hyperbilirubinemia
(3) hydrogen sulfide poisoning, or from putrefaction
Distinguishing features in the neuropathologic exam:
(1) hyperbilirubinemia: patchy distribution, involvement of the white matter and periventricular tissues, may localize to sites of intracerebral hemorrhage
(2) methylene blue: diffuse distribution, spares the white matter, and involves the periventricular area and brainstem
(3) hydrogen sulfide: diffuse distribution, spares the white matter, spares the periventricular tissue and brainstem
Other organs may also show greenish discoloration.
Some possibilities not mentioned in the article:
(1) Pseudomonas aeruginosa meningitis
(2) intravenous injection of another dye or chemical
