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The death certificate of a relative who died in Spain in 1887 states the cause of death was a midbrain congestion (congestión del mesencéfalo in Spanish). He died in a psychiatric hospital at the age of 41.

What does it mean to die from congestion of the midbrain?

Some family stories assure he committed suicide. Is this compatible with the recorded cause of death?

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  • This question isn't very well suited for MedSci because it can't produce a certain answer supported by facts. Answers can only be speculative. However, a little searching around produces some pretty good clues, so I'll go ahead and take a shot at an answer. – Carey Gregory Dec 13 '19 at 23:01
  • "Death through bloodcongestion in midbrain".could be a way of circumnavigating saying "death through impact to head by blunt object". If this was the case the subject was murdered by the impact of a blunt object, such as a hammer. Alternatively, the subject was tripped, or tripped, and died of the impact of the hard floor. – Constantthin Dec 22 '19 at 5:04
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Although I doubt that term would be applied to a suicide in a modern country, death records can be unreliable in other times and other cultures when suicide was involved. 100+ years ago suicide was often considered shameful and embarrassing to the family, so it's possible the death record was falsified to protect the family name. Since we have no way of ruling suicide in or out, it's a moot question that I will ignore.

I think the most likely explanation is your relative died of a stroke, head injury or brain tumor that caused increased intracranial pressure. Congestion in the brain usually refers to venous congestion, meaning blood isn't being drained from the brain normally so it's backing up. Venous congestion can be caused by several things but since no mention was made of head injury, the most likely explanation in a 41 year old man would probably be an expanding mass. A tumor that was growing, causing increased intracranial pressure, and possibly physically pressing on the veins that drain the mid-brain region would seem like the most likely explanation.

There are several uses of the phrase "congestion of the midbrain" found in neurology texts and they all occur in the context of expanding masses. I can't copy/paste from Google Books so you'll have to follow the links to read it as text.

Google Books 1

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Google Books 2

enter image description here If you search on the more common English wording "midbrain congestion" you'll find many more references, most of them also discussing brain tumors and other causes of increased pressure within the skull. Google finds no hits at all on the Spanish expression "congestión del mesencéfalo."

Remember, this is completely speculative.

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    Before you posted this I was writing a comment to suggest roughly the same thing - brain hemorrhage or edema, although there could easily be a translation difference from the English medical meaning of 'congestion' (and could also be a translation that has different meaning then versus now). Adding to speculation, I wouldn't necessarily trust death records especially from 100+ years ago to be particularly reliable on suicide - there's really no way to know either way. – Bryan Krause Dec 13 '19 at 23:08
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    @BryanKrause Agreed on all points, which is why the disclaimer at the end. – Carey Gregory Dec 13 '19 at 23:11
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    Yeah, I figured as much, though your answer still starts with "I can't imagine why that term would be applied to a suicide" which is why I commented :) – Bryan Krause Dec 13 '19 at 23:48
  • @BryanKrause Good point. I'll edit to make the point about death records and suicide. – Carey Gregory Dec 13 '19 at 23:49
  • It seems "congestive fever" was a common term in the 1800s referring to death from malaria; might be plausible for 1800s Spain but I'm not sure why the midbrain would be mentioned specifically. – Bryan Krause Dec 14 '19 at 0:22

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