1/24. Recurrent psychogenic coma following tracheal stenosis repair.Medication, intracranial hemorrhage, infarction, infection, hypoxia, organ failure, and nutritional deficiency may cause unconsciousness following successful emergence from anesthesia. A 39-year-old woman with a history of tracheal stenosis, depression, and anxiety had complete unconsciousness on 3 separate occasions following surgical repair of her tracheal stenosis. In each case, the patient's endotracheal tube had been removed; she was alert and oriented to person, time, and place; and she was admitted to the hospital for observation. Within a few hours after the tube was removed, the patient became abruptly unconscious for periods of 36, 18, and 30 hours. Each time, the results of cardiac, pulmonary, metabolic, and neurologic examinations and radiological studies were normal. We hypothesize that the patient's apparent comas were the result of an underlying conversion disorder precipitated by unresolved psychological conflict surrounding a long history of abuse in which she was repeatedly smothered by a pillow.- - - - - - - - - - ranking = 1keywords = unconsciousness, unconscious, consciousness (Clic here for more details about this article) |
2/24. Asphyxial death during prone restraint revisited: a report of 21 cases.Determining the cause of death when a restrained person suddenly dies is a problem for death investigators. Twenty-one cases of death during prone restraint are reported as examples of the common elements and range of variation in these apparently asphyxial events. A reasonable diagnosis of restraint asphyxia can usually be made after ruling out other causes and collecting supportive participant and witness statements in a timely fashion. Common elements in this syndrome include prone restraint with pressure on the upper torso; handcuffing, leg restraint, or hogtying; acute psychosis and agitation, often stimulant drug induced; physical exertion and struggle; and obesity. Establishing a temporal association between the restraint and the sudden loss of consciousness/death is critical to making a correct determination of cause of death.- - - - - - - - - - ranking = 0.0034090819874751keywords = consciousness, state (Clic here for more details about this article) |
3/24. Hanging-delayed death (a rare phenomenon).Hanging is one of the most common methods of suicide in india in which death of the individual occurs instantaneously. However, a few cases have been reported in literature in which death has occurred after a certain period of time or the patient has survived after prolonged resuscitative measures. A case of a 20-year-old female is described who survived for nine days after hanging, remaining unconscious throughout in the hospital. She died due to cerebral damage caused by cerebral anoxia.- - - - - - - - - - ranking = 0.036355259932199keywords = unconscious (Clic here for more details about this article) |
4/24. An autopsy case of accidental asphyxiation in a storage room for apples.A 12-year-old boy died in a storage room and his mother was rescued from the same storage room, where many apples were being stored. The atmosphere in the room was strictly controlled and the concentration of oxygen (O2) was recorded. The cause of death was suffocation. According to the records, the concentration of O2 was about 2.7% when the boy died. On the other hand, it was about 3.4% when his mother entered the room and she survived, although she remained unconscious for about four hours. These findings show that the absolute concentration of O2 causing acute death due to O2 deficiency is approximately 2.5-3.0%.- - - - - - - - - - ranking = 0.036355259932199keywords = unconscious (Clic here for more details about this article) |
5/24. Self strangulation by hanging from cloth towel dispensers in Canadian schools.OBJECTIVE: To investigate a local "epidemic" of incidents of strangulation by hanging from continuous cloth towels in dispensers. METHOD: The coroner's office in all provinces and territories were contacted. Five cases of hanging from continuous cloth towels in Canadian schools were identified and reviewed. RESULTS: There were four deaths, and one near-death, all males age 7 to 12. Two cases were attributed to a "choking game" that provides a sensation (impending loss of consciousness) described as "cool". In three cases, the child was alone at the time. All deaths were due to strangulation from hanging and all occurred in school washrooms. One child (playing with two friends) recovered after admission to an intensive care unit. Towel dispensers were removed from the two index schools. In one province the Ministry of education encouraged removal of towel dispensers from all schools and education of students of the dangers of "choking games". CONCLUSIONS: Thrill seeking from partial asphyxiation appears to underlie these incidents. awareness of such cases should prompt appropriate education strategies to highlight the serious consequences of this form of risk taking behavior in young males. In canada, these incidents have resulted in changes in the design of, and legislation regarding, cloth towel dispensers.- - - - - - - - - - ranking = 0.0033669414751443keywords = consciousness (Clic here for more details about this article) |
6/24. Accidental hanging by a sweater: an unusual case.An accidental atypical hanging with the collar of a sweater is reported. A 67-year-old man was found dead in the sitting position with the collar of his sweater hanging off the brake handle of a motorcycle. autopsy findings revealed a ligature mark on the surface of the neck; hemorrhages in the sternohyoid muscles; submucosal hemorrhages in the left greater horn of the hyoid bone; a large degree of submucosal petechial hemorrhages in the larynx, oral mucosa, and palpebral conjunctivae; and dark-red liquid blood with little clotting in the heart cavities. The alcohol levels in the blood and urine were 2.84 mg/ml and 3.52 mg/ml, respectively. It was concluded that the man had died from hanging by the sweater, and it was speculated that when he became inebriated, he might have lost consciousness and then fell with the collar of his sweater hanging from the brake handle of the motorcycle.- - - - - - - - - - ranking = 0.0033669414751443keywords = consciousness (Clic here for more details about this article) |
7/24. Contributing factors to engulfments in on-farm grain storage bins: 1980 through 2001.Since 1978 Purdue University has maintained a national database of agriculture-related engulfment cases that have occurred in loose agricultural material in both commercial and on-farm facilities. The database presently contains 502 documented cases of fatal and non-fatal engulfments from the U.S. and canada. A review of the more recent on-farm fatal and non-fatal engulfment cases, those occurring in 1980 through 2001, was conducted in order to characterize engulfments and identify contributing factors that would be relevant to future intervention strategy development including the implementation of design standards for on-farm structures. From 1980 through 2001, 197 cases were identified that occurred in on-farm grain bins, 156 of which were fatal and 41 were non-fatal. A rate of approximately seven fatal and two non-fatal cases per year were identified from 1980 through 2001. The magnitude of the engulfment problem is continuing, based on six and seven fatal cases reported in the years 2000 and 2001, respectively. Sixteen percent of fatal and six percent of non-fatal victims were children and adolescents under the age of 16. Fifty percent of the survivors were 60 years of age or older. Engulfments were generally reported more often in the top corn-producing states and involved corn in 76% of the fatal cases when product was known. Seventy-seven percent of the fatal victims were unloading the bin at the time of engulfment in cases where activity at the time of engulfment was known. Forty-one percent of the fatality cases involved corn that was out-of-condition where the condition of the grain was known. In survival cases where information about the presence of co-workers at the time of engulfment was known, it was found that a co-worker was present at the time of engulfment in 86% of the cases. In four cases, a survivor was rescued from a bin after being completely engulfed in grain. In all four cases, a co-worker was present at the time of engulfment and out-of-condition grain was involved. Findings are being used to design new injury prevention strategies, including educational materials and recommendations for engineering controls that focus on primary causative factors.- - - - - - - - - - ranking = 4.2140512330832E-5keywords = state (Clic here for more details about this article) |
8/24. Suffocation and poisoning--the hard-hitting side of munchausen syndrome by proxy.munchausen syndrome by proxy (MSBP) is a severe and difficult to diagnose form of child abuse characterised by the simulation, aggravation or production of symptoms of illness in a child by an adult. MSBP often leads to multiple hospitalisations and has a high mortality and long-term morbidity. This study describes the cases of 5 families with 8 children affected who presented with unexplained neurological or gastrointestinal symptoms or even loss of consciousness. All were victims of poisoning or suffocation by their mothers. Two of those children died and were initially diagnosed as SIDS or natural death, respectively. They were only recognised as MSBP victims after another sibling had fallen ill with similar symptoms. The cases are discussed in consideration of the relevant literature. In addition warning signs of this forensically relevant syndrome and a strategy for the management of suspected MSBP cases are described.- - - - - - - - - - ranking = 0.0033669414751443keywords = consciousness (Clic here for more details about this article) |
9/24. Death due to positional asphyxia under severe alcoholisation: pathophysiologic and forensic considerations.In contrary to "physical restraint", describing a fixed body position due to external devices, "positional restraint" is defined as an abnormal body position, resulting from accidental fixation under unfortunate circumstances. We report on a remarkable case of positional asphyxia of an alcoholised young man after a fall down a staircase. On external examination, the body showed petechiae of the conjunctivae and oral mucosa, abrasions on the left zygomatic region and scratch marks, respectively. Neither broken fingernails, etc. nor signs of external violence against the neck were found. autopsy revealed haemorrhages in the praevertebral cervical musculature and Simon's sign. Haemorrhagic pulmonary edema and cerebral edema were observed; blood alcohol concentration: 2.60 g/l, urine alcohol concentration: 3.26 g/l. As cause of death, positional asphyxia after blunt head trauma has to be considered as well as lethal ethanol intoxication. To us, alcoholisation attributed to the fall and together with unconsciousness following blunt head trauma circumvented self-rescue efforts, and therefore, aggravated the potentially lethal impact of positional restraint.- - - - - - - - - - ranking = 0.4818223700339keywords = unconsciousness, unconscious, consciousness (Clic here for more details about this article) |
10/24. Accidental childhood strangulation by human hair.A low-income mother is accused of child abuse after co-sleeping with, and then waking to find her 13-month-old daughter entangled and apparently strangling in the mother's hair. The baby was initially unconscious and cyanotic; revived by the time the parents reached the ER, clinical examination revealed a ligature mark on the neck and petechiae on the face. In a pro bono effort, her attorney teamed with RAM Consulting as an expert witness. RAM performed a six-part investigation including: (1) an anthropometric analysis, (2) determination of the strength of human hair, (3) characterization of the ligature mark, (4) an investigation into airway occlusion forces, (5) an investigation into the conditions required to initiate petechiae, and (6) a review of the literature. Our conclusion was that it is possible for a strangulation incident to occur when a young child is co-sleeping with a parent with long hair, and that this scenario may result in injury or death. Upon review of this report and RAM's deposition on this matter, the prosecuting attorney's expert witness withdrew her testimony and the judge dismissed the case.- - - - - - - - - - ranking = 0.036355259932199keywords = unconscious (Clic here for more details about this article) |
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