Forensic pathological aspects of postmortem imaging of gunshot injury to the head: documentation and biometric data (original) (raw)
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Routine techniques in forensic neuropathology as demonstrated by gunshot injury to the head
Legal Medicine, 2009
It will be vital to the practical activity of every forensic and/or clinical pathologist to be able to answer three questions regarding the reconstruction of a lethal event: the type and cause of death, as well as the survival time. The authors offer an overview of the application of selected morphological techniques in general forensic neuropathology, techniques that provide answers to some of the main questions in forensic neurotraumatology. The methods are illustrated by individual cases of lethal gunshot injury to the head from low velocity handguns.
International Journal of Legal Medicine, 2019
The aim of this study is to assess the added value of post-mortem computed tomography (PMCT) in fatal shooting incidents compared with autopsy findings. For this study, the analysis was restricted to the following four features: location of the entrance and exit wounds, internal injuries, location of projectiles or metal fragments and course of the trajectories. These features were selected because they provide essential information on the cause and manner of death. All data were retrospectively collected from medical forensic examinations of fatal shooting incidents in the Netherlands that occurred in 2010-2014. Twenty-one fatal shooting victims were included in this study, with a total of 100 trajectories. For all 100 trajectories, the forensic radiologist and pathologist came to a consensus on which examination had the highest diagnostic value for each of the four features. PMCT provides superior information on the presence of metal fragments, internal injuries and the course of trajectories. PMCT provides limited information on the discrimination of entrance and exit wounds. In conclusion, PMCT provides additional relevant information in over 60% of forensic medical examinations of deceased victims of shooting incidents. We therefore recommend adding PMCT as a standard examination in these cases.
Gunshot injuries to the head and brain caused by low-velocity handguns and rifles
Forensic Science International, 2004
Objectives: Reconstruction of brain injuries is a basic task of forensic neuropathology. For better understanding of the wound ballistics of gunshot injuries to the brain caused by low-velocity firearms (E o < 550 J), we reviewed the respective contributions of: (1) biomechanical reconstruction by postmortem imaging techniques, (2) biometry of the extent of very early microscopic tissue destruction, and (3) microscopic studies on the type and extent of early microscopic reactions around the permanent missile track. Material and methods: A selected case material of 47 victims of lethal gunshot wounding to the brain was studied.
Forensic Science International, 2003
Because the use of radiology in modern forensic medicine has been, until today, mostly restricted to conventional X-rays, which reduces a 3D body to a 2D projection, a detailed 3D documentation of a gunshot's wound ballistic effects was not possible. The aim of our study was to evaluate whether the progress in imaging techniques over the last years has made it possible to establish an observer-independent and reproducible forensic assessment using multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) technologies for the documentation and analysis of gunshot wounds. The bodies of eight gunshot victims were scanned by MSCT and by MRI; the data of these imaging techniques were post-processed on a workstation, interpreted and subsequently correlated with the findings of classical autopsy.
Medico Legal Autopsy of an Atypical Firearm Skull Inlet: A Case Report
Journal of Medical Toxicology and Clinical Forensic Medicine
Firearm injuries contribute to considerable morbidity and mortality. The ricocheting bullet is a high-velocity bullet after interacting with intermediate object. Ricocheting bullet produces a unique wound, its mechanics have been discussed from time to time. The case presented an atypical presentation of firearm entrance wound , where the entry wound situated on left temporal skull region with surrounding abrasions in addition the bullet entered the cranial cavity to cause an exit fracture defect situated on right temporal skull region with brain disruption. Our case emphasizes that forensic doctors should carefully interpret the properties of atypical firearm entry wound.
2015
Background: Firearm injuries may cause physical disabilities, permanent infirmities, psychological harm or death of injured individuals. Multi-detector computed tomography (MDCT) became a mainstay noninvasive diagnostic tool in investigation of firearm injuries as it gives three dimensional imaging (3-D) and colored images. Objective: This study was designed to through light on the role of MDCT in medicolagal evaluation of non-fatal firearm injuries in the head which examined in Assiut University hospital. Subjects and Methods: this study was conducted on 67 cases of non-fatal firearm injuries in the head including an age group 16-70 years which presented in the trauma unit and outpatient clinic of neurosurgery department during the period from June 2013 to June 2015. After forensic examination, the cases were examined blindly by two consultant radiologists using 16-row multi-detector CT in diagnostic radiology department of Assiut University hospital after giving an informed consent. The obtained images were post-processed using an advanced diagnostic computer workstation to obtain multi-planar reformatted and three-dimensional volume-rendered images to examine soft tissues, skull and intracranial structures. The relevant disclosing MDCT images were documented, interpreted and data were discussed between participants of the research from departments of the forensic medicine and diagnostic radiology and compared to results of forensic examination. Statistical analysis of data was done. Results: Most of injuries occurred in males which represented 89.45% of total cases and the highest percentage of victims was in the age group 21-30 years which represented 31.3%. MDCT images help in determining details of inlets and exits (in soft tissue, bone and intracranial structures), recognizing the type of used firearm weapons (weapons firing shots represented 73.1%), retained projectiles, determination of the distance of firing (79.1 % of total). In addition it demonstrated retained projectiles which represented 46.3% of total cases and their details (types, numbers, shapes, sizes, trajectory and deflection inside the skull), intracranial hemorrhage, edema, skull fractures. It can help in determination of permanent infirmity (which represented 17.9% of total cases) and in planning for surgical interference. Conclusion: This study demonstrated that MDCT is an accurate diagnostic tool in the medicolegal investigations of firearm injuries. The MDCT images are documented forensic evidence which can be stored, electronically sent for medicolegal consultation and can be shown in the court. In addition, medicolegal experts can trust on MDCT for determination of permanent infirmities which can help injured persons to obtain compensations and determine responsibility of physicians about faults in malpractice claims.
High-Speed Documented Experimental Gunshot to a Skull-Brain Model and Radiologic Virtual Autopsy
The American Journal of Forensic Medicine and Pathology, 2002
The authors documented and evaluated experimental gunshots to a skull-brain model with high-speed photography and subsequent radiographic examination for comparison of the morphologic findings in the model. The artificial skull was a polyurethane ball constructed in layers, with a porous diploe sandwiched between a tabula externa and a tabula interna. The brain itself was simulated with gelatin 10% at 4°C, a material well known in wound ballistics. Gunshots were fired at the model from a distance of 10 m and documented with highspeed photography (up to 50 million frames/sec). Subsequently, a complete examination of the artificial skull was performed, including spiral computed tomography (with twodimensional and three-dimensional reconstructions) and classic skull autopsy. The high-speed photographs clearly showed the dynamic development of the skull fracture system from an external perspective. The subsequent radiographic examination of the entire head volume created two-dimensional reformations in any plane and three-dimensional reconstructions of the gunshot injury of the polyurethane skull-brain model, especially the wound channel and the fracture system. Thanks to the model and high-speed photographs, the dynamic development of the morphology of a gunshot wound could be documented and studied. The data from computed tomography, using twodimensional and three-dimensional postprocessing with a perspective view, were very similar to those from classic head autopsy, but derived in a hands-off and nondestructive manner. This examination method leads the way to radiographic digital autopsy or virtual autopsy.
Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series
Journal of Forensic Sciences, 2020
Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner's office that occurred during 2016. Autopsies were performed or supervised by board-certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re-evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head-neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar's test. We included 60 males and 20 females (median age 31 years, range 3-73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head-neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.
Importance of 3D-CT imaging in single-bullet cranioencephalic gunshot wounds
La Radiologia medica, 2012
The aim of this paper is to demonstrate that computed tomography (CT) and three-dimensional (3D) CT imaging techniques can be useful tools for evaluating gunshot wounds of the skull in forensic medicine. Three purposes can be achieved: (1) identifying and recognising the bullet entrance wound - and exit wound, if present; (2) recognising the bullet's intracranial course by studying damage to bone and brain tissue; (3) suggesting hypotheses as to the dynamics of the event. Ten cadavers of people who died of a fatal head injury caused by a single gunshot were imaged with total-body CT prior to conventional autoptic examination. Three-dimensional-CT reconstructions were obtained with the volume-rendering technique, and data were analysed by two independent observers and compared with autopsy results. In our experience, CT analysis and volumetric reconstruction techniques allowed the identification of the bullet entrance and exit wounds and intracranial trajectory, as well as helpin...