Cases reported "Neck Injuries"

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1/38. Tentative injuries to exposed skin in a homicide case.

    A 28-year-old man stabbed both his wife and his 3-year-old son to death, before unsuccessfully attempting to commit suicide. The incident occurred against a background of marital conflict. The child's body exhibited six tentative wounds to the skin in the area of the heart, with no corresponding defects in the overlying clothing, a pattern normally seen only in suicide. Their presence can be explained by the fact that this can be considered an extended suicide, the father's motivation for the killing being comparable to that for true suicide. However, wounds of this nature can be produced in such cases only if the victim is severely limited in his ability to defend himself, here due to the superior physical strength of the father.
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2/38. death caused by a chain saw--homicide, suicide or accident? A case report with a literature review (with 11 illustrations).

    A 31-year-old farm worker was found dead beside a chain saw. Based on the testimony of a colleague and because of the situation at the site, the police very soon presupposed an accident. It was assumed that the victim had slipped on the sudden ground and had been killed by the subsequent swerving of the saw when starting the engine. The body presented with a deep lacerated wound at the right side of the nape of the neck, including the first cervical vertebra, the medullary canal and the right mandible as well as multiple fissures of the occipital bone, which were attributed to repeated forceful use of the chain by another person. A second wound with relatively sharp edges and a tangential fissure in the corresponding area of the skull raised the suspicion that an axe or some similar device had been used. Although the forensic medical findings seemed to give clear evidence of external violence, no further investigations have been carried out so far by the authorities.
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3/38. Management of penetrating injury to the petrous internal carotid artery: case report.

    We report the management of a penetrating foreign body injury to the neck with a length of fencing wire traversing the internal carotid artery within the petrous temporal bone and entering the middle cranial fossa. Discussion points include methods of haemorrhage control, as well as ligation versus repair or bypass as the definitive treatment.
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4/38. decapitation as a result of suicidal hanging.

    A report is presented on a 47 year old man who committed suicide by hanging himself from a staircase bannister of an apartment house. The man, weighing 144 kg jumped with the noose of a 2 cm thick and 2 m long hemp rope around his neck and was completely decapitated. death from typical "normal" suicidal hanging is usually due to cerebral ischaemia caused by compression of the carotid (and vertebral) arteries. Except for bleeding at the clavicular insertions of the sternocleidomastoid muscles there are only occasional injuries to the cervical soft parts or hyoid bone and/or laryngeal cartilage. A fall with a noose around the neck, on the other hand, is associated with more frequent injuries to cervical structures through additional axial traction and radial shearing forces of the tightening noose. Complete decapitation can occur in rare cases under extreme conditions (heavy body weight, inelastic and/or thin rope material, fall from a great height).
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5/38. Traumatic intracerebral venous thrombosis associated with an abnormal golf swing.

    OBJECTIVES: To describe the occurrence of cerebral venous thrombosis in a 40-year-old man whose cerebral event was induced by a poor golf swing, to review the literature on possible mechanisms producing venous thrombosis, and to compare this case with the literature. BACKGROUND: headache is the most frequent symptom in patients with cerebral venous thrombosis. However, patients presenting with a headache due to cerebral venous thrombosis are uncommon. The known risk factors for thrombosis include both acquired and genetic factors. When the interaction of these two groups occurs, the magnitude of this interaction is thought to produce a dynamic state that can favor thrombosis. Our case report illustrates that moderate levels of anticardiolipin antibodies together with the mild trauma of a golf swing can induce a cerebral venous thrombosis. This case also suggests that although headache is rarely due to cerebral venous thrombosis, it should be excluded by good medical acumen and testing. RESULTS: Minor trauma induced by a poor golf swing was chronologically related to the development of a progressive cerebral venous thrombosis. The patient had none of the risk factors associated with a predisposition to venous thrombosis: hypercoagulable state, concurrent infection, pregnancy/puerperium, collagen vascular disorder, malignancy, migraine, false-positive VDRL, previous deep vein thrombosis, renal disease, factor v Leiden, or a hematological disorder. There was no anatomical abnormality that would predispose the patient to a cerebral venous thrombosis. The only laboratory abnormality was a moderate anticardiolipin antibody level (25 GPL). The patient was placed on warfarin sodium therapy and is currently without clinical sequela from the venous thrombotic event. CONCLUSIONS: Under certain circumstances, minor trauma can induce cerebral venous thrombosis. A review of the literature indicates that cerebral venous thrombosis in the presence of anticardiolipin antibodies and in the absence of systemic lupus erythematosus is a rare event. Previously, only major traumatic events have been reported to be associated with cerebral venous thromboses. The chronological development of cerebral venous thrombosis after a faulty golf swing strongly indicates that given a background of moderate levels of anticardiolipin antibodies, even minor trauma can induce a venous thrombotic event.
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6/38. Transcervical foreign body.

    The uncommon occurrence of acute retropharyngeal abscess in adults can be the result of a retained foreign body. A large piece of wood impacted in the neck in a road traffic accident and presenting as retropharyngeal and bilateral parapharyngeal abscesses is reported for its rarity and clinical interest.
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7/38. Suicides by sharp force: typical and atypical features.

    A total of 65 consecutive cases of suicide by sharp force were investigated by evaluating the autopsy and prosecution department records. Suicides constituted 17% of all fatalities from sharp force autopsied between 1967 and 1996. Young males and persons with a psychiatric history predominated among the persons who chose this "hard" method of suicide. The most common implements used were knives (62%) and razor blades (15%). Cutting injuries in isolation were present in 26, stab injuries in isolation in 24 and a combination of both in 15 fatalities. The number of injuries per case varied from 1 to 37 but 1/3 showed one injury. More than 85% of the cutting injuries were located at the wrist, elbow crease or neck whereas 79% of the stab injuries involved the ventral aspect of the trunk. Perforation of clothing was present in 16 (52%) out of 31 stab injuries to the trunk. Injuries to more than one body region were observed in 34 (52%) cases. Tentative marks were present in 50 (77%) fatalities and the number varied from 1 to 60 per case. Superficial incisions of the fingers were found in 15% with razor blades constituting the weapon in half of these cases. Deviations from these typical patterns occurred not infrequently. The utter determination of the victim to carry it through or the use of unusual weapons resulted in a few bizarre cases which are outlined briefly.
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8/38. Foreign body in injury--an important evidence.

    In the present paper, a complete case is discussed, that is from the crime upto judgement in the court of law, from the Forensic point of view. The postmortem examination was conducted by the author in which a metallic fragment of size of a mustard seed was found in a incised wound. On chemical analyzers examination, the metal fragment matched with the suspected weapon, in respect of spectrochemical contents. This evidence became an important part in the investigation for conviction of the accused in the court of law. This indicates that when-ever any foreign body, whatever it may be or of whatever size, should not be neglected while examining the injury before death of after death, since it can become an important piece of evidence.
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9/38. Incomplete decapitation of a motorcyclist from hyperextension by inertia: a case report.

    This is a rare case involving a motorcyclist. A 57 year old motorcycle rider wearing a full face type helmet, suffered incomplete decapitation. The autopsy findings revealed a wide lacerated wound accompanied by extension marks in the front neck, atlanto-occipital dislocation and complete transection of the brainstem. According to the police traffic report, the man's head was stationary at the moment of impact and the remainder of the body continued in a backward motion. We concluded that the inertia of the torso caused hyperextension of the neck and subsequent incomplete decapitation.
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10/38. Victim's scalp on the killer's head. An unusual case of criminal postmortem mutilation.

    A case of unusual postmortem mutilation of a victim's body is presented. After killing his father, the son decapitated his body and dissected the scalp free, forming a mask of the father's head and neck. The young man wore the scalp-mask over his own head to imitate the father. The motive of the murder was revenge, and the postmortem mutilation was the realization of the perpetrator's fantasies, symbolically representing a penalty for the reprehensible past life of his father.
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