hydrocodone and Glioblastoma

We encountered a decedent with an unexpected glioblastoma multiforme. A 61-year-old retired African-American woman was found dead in her home, fully clothed in her bathtub, with a pillow under her head. At autopsy, the brain showed a glioblastoma multiforme. Toxicology showed elevated hydrocodone, propoxyphene, acetaminophen, and positive paroxetine. The presence of a brain tumor likely caused a severe headache. The use of her medications could have indicated a reaction to the escalating pain of the brain trauma, and overuse could be consistent with escalating pain or loss of rational thought processes. The present case is interesting in that it had evidence of behavioral dysfunction that could be related to the brain tumor, and death arising from the glioblastoma multiforme (cerebral hemorrhage and edema) with concurrent multiple drug intoxication.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Analgesics, Opioid; Brain Edema; Brain Neoplasms; Dextropropoxyphene; Female; Forensic Pathology; Forensic Toxicology; Glioblastoma; Headache Disorders, Secondary; Humans; Hydrocodone; Intracranial Hemorrhages; Mental Disorders; Middle Aged; Paroxetine; Selective Serotonin Reuptake Inhibitors; Self Medication; Vitreous Body