Diagnosis of Hemorrhagic Stroke in an Exhumed Brain After Three Years of Burial in a Deep Grave

Abstract: We present the forensic neuropathologic analysis of an exhumed decomposed brain following long‐term interment in a 50‐year‐old white woman, who had been buried for 34 months. Next of kin authorized exhumation of the body for an autopsy to determine the cause of death. The embalmed body was anatomically intact and revealed decompositional changes with mold colonies. Internal viscera showed intact histomorphology. The brain revealed diffuse congestive swelling and extracellular edema with dissecting parenchymal hemorrhage and hematoma originating from the left putamen and thalamus and extending to the left lateral ventricle. Excitotoxic neuronal injury as well as penumbric parenchymal changes was noted. Cause of death was determined to be a hypertensive cerebral parenchymal hemorrhage. This case and our previously reported case are sentinel cases, which should encourage and guide the forensic neuropathologic work‐up and investigation of causes of death in spite of long‐term burial in deep graves.     

A Preliminary Examination of Differential Decomposition Patterns in Mass Graves

Five pairs of mass graves, each containing carcasses of 21 rabbits, were used to examine differential decomposition at four locations within the burial: surface, deep, mid‐outer, and core. Every 100 accumulated degree days (ADD), a pair of graves was exhumed, and total body score (TBS) and internal carcass temperature of each rabbit were recorded. Decomposition did not differ for core‐ and deep‐positioned carcasses (p = 0.13); differences were significant (p < 0.001) for all other location comparisons. Decomposition occurred fastest in shallow carcasses, followed by mid‐outer carcasses; deep and core carcasses decomposed slowest and at rates not significantly different from one another. Adipocere formation was minimal and confined to deep carcasses. Carcass location within the mass grave significantly influenced internal carcass temperature (p < 0.001); a mean internal temperature difference of ca. 1°C existed between deep and shallow carcasses (30 cm apart). Effects of mass compactness and oxygenation require further investigation.     

Identification process in mass graves from the Spanish Civil War II

The identification process of a mass grave from the Spanish Civil War (1936-1939) is presented. The presumed location of the grave, as well as the presumed number and identities of the persons buried in the grave were obtained exclusively from witnesses' and relatives' testimonies. In agreement with the testimonies, the grave was located at the indicated location and five skeletons were exhumed. Also in agreement with the testimonies, the osteological and DNA study led investigators to propose the identification of two kin groups, a father and his son and a pair of brothers. But the genetic study did not support the identification of a fifth man presumed to have been buried in the grave. The differences and similarities between this case and another case reported earlier are discussed.     

Chronic Traumatic Encephalopathy Pathology After Shotgun Injury to the Brain

Chronic traumatic encephalopathy (CTE) was initially conceptualized in boxers, but has extended to other athletes in recent years, albeit with limited clinical correlations. It is often asserted that CTE pathology represents the substrate for progressive neurodegenerative disease. We report the case of a shotgun injury to the brain with 42‐year survival and no neurological disease progression until shortly before death. The decedent had no other traumatic brain injury (TBI) exposure and did not play football or other high energy collision sport. Neuropathological examination confirmed tissue damage, but additionally demonstrated localized patterns of phosphorylated tau (p‐tau) meeting criteria for CTE pathology. P‐tau and TDP‐43 deposits within marginal tissue of damaged brain were also present focally. No amyloid‐β (Aβ) deposits were present. These findings indicate that CTE pathology may occur following a single, severe TBI.     

大鼠闭合性脑损伤酯化银和白蛋白组织化学研究

目的 研究闭合性脑损伤立即死亡和伤后 15min至 5天的大鼠脑组织病理变化。方法 应用 HE染色法观察闭合性脑损伤的组织形态学变化。结果 伤后立即死亡组大鼠脑干、大脑和小脑大量神经元表现为皱缩 (Ⅰ型变 )和肿胀 (Ⅱ型变 ),脑干大片神经纤维波浪样变形;伤后 2～ 8h,出现神经元水肿和轴索肿胀明显;伤后 8～ 24h,出现轴索收缩球。之后,Ⅰ型变、Ⅱ型变和收缩球随存活时间延长而增多加重。伤后 4～ 5天,组织水肿减轻或消失,收缩球仍存在。酯化银染色观察,各种损伤性改变均较 H.E.染色更清晰。 ABC法,血浆 Al随伤后时间延长,从血管周围逐渐向周围扩散,并进入损伤的神经元和胶质细胞。结论 脑震荡性损伤改变呈冲击性、对冲性和向心性分布。     

An Unusual Suicide Inside a Grave with Two Gunshot Wounds to the Head—The Psychological Approach

Abstract: In this report, the authors present a case of suicide committed by a 66-year-old man, inside a grave at the local cemetery, with two gunshot wounds to the head. A multiple-paged, handwritten suicide note was found in an army type bag inside the victim’s car, while a second one was found in his house. Medicolegal examination of the body revealed two typical contact gunshot entrance wounds and one exit wound to the head. Toxicological analysis of the femoral blood was negative for alcohol and drugs. The history, scene and autopsy findings, along with further police investigation, indicated an obvious case of suicide. The literature is reviewed and discussed. We report this case as the place of suicide is extremely uncommon and as there is no mention of a gunshot suicide inside a grave in the current literature.     

Osteological case study to narrow the timing of postmortem trauma to a skull

In the course of an exhumation performed 5.5 years after death, several bone fragments were uncovered during the excavation of the clay-rich soil. Amongst others, there was a large piece of the frontal neurocranium. In addition, a so-called coffin stain was discernible. The exhumed coffin was intact. The forensic autopsy revealed a complete corpse with distinct adipocere formation. Consultation with the cemetery administration allowed the conclusion that the additional bone fragments were from the first use of the grave approximately 100 years ago. The heavily soil-encrusted skull fragment bore clear signs of a half sharp force, that could immediately be classified as postmortem. The pattern of injury pointed to an excavator as the cause. However, the question arose whether the postmortem trauma occurred 5.5 years ago during the excavation of the grave or during the current exhumation. First the skull fragment was dried. However, it was then impossible to remove the clay-rich soil without damaging the bone. The fragment was therefore carefully washed and dried again. The cut and fracture areas then showed distinctly lighter surfaces than the rest of the bone, which pointed to the exhumation as the time of origin. For comparison, fresh injuries were inflicted with a hatchet. These distinctly showed even lighter surfaces, so that the time of origin could be assumed to have been during the excavation of the grave 5.5 years ago.     

A case of commingled remains from rural South Africa

In the spring of 2003, bush cutters discovered a large grain bag filled with human skeletal remains in a forest in South Africa. Differential taphonomic processes observed on the bones suggested that the individuals had not died at the same time or had decomposed under different circumstances. The remains were sorted using gross morphological techniques which included assessing the number of skeletal elements present, visual pair matching, articulation, process of elimination and taphonomy. Standard techniques were used to estimate age, sex, racial affinity and stature. A minimum number of individuals (MNI) of 10 was established, which included 7 adult males, 1 adult female and 2 juveniles. Trauma was observed on only one individual. Approximately, 80% of the skeletal remains were missing. These various skeletal elements may have been lost by accident, normal taphonomic processes or taken by scavengers. Possible origins for these skeletal remains include removal from a formal grave, found in the veldt or murdered.     

Mites (Acari) as a Relevant Tool in Trace Evidence and Postmortem Analyses of Buried Corpses

This report interprets the presence of mite species in three clandestine graves in Europe, evaluating their potential use as trace evidence or markers. Grave 1 (Sweden): Two mite species Rhizoglyphus robini Claparède, 1869 and Parasitus loricatus (Wankel, 1861) were recovered from the surface of a body buried in a shallow grave in an area surrounded by trees, in close vicinity to house gardens. Grave 2 (Germany): Phoretic deutonymphs of Gamasodes spiniger (Trägårdh, 1910) were attached to an adult fly (Diptera: Sphaeroceridae) found within a shallow grave containing two human bodies covered in soil and dung. Grave 3 (France): P. loricatus were recovered from the soil around a body buried in a deep grave (80 cm under). In graves 1 and 3 both corpses were undergoing advanced decay and skeletization, the locations match with the subterranean habit of P. loricatus, highlighting the value of this species as a marker of graves or burials in soil and during late decomposition. R. robini is a soil mite that feeds on decayed roots and bulbs; this mite species confirms the location of the corpse within top soil, agreeing with a more specific type of superficial burial, a shallow grave. In case 2, the presence of both coprophiles, the mite G. spiniger and the carrier fly confirm association of remains with dung or animal feces. The three mite species are reported for the first time in human graves. There are no previous records of R. robini from Sweden.     

The effect of soil type on adipocere formation

Adipocere refers to a postmortem product which forms from body fat in the later stages of decomposition. Factors present in the surrounding decomposition environment will influence adipocere formation and may accelerate or retard the process of conversion. One such factor important in burial environments is the type of grave soil in which the burial has taken place. This study was conducted to investigate the influence of various soil types on the formation of adipocere in grave soils. X-ray diffraction and particle size analysis were used to characterise the soils which were essentially chosen on the basis of grain size. Infrared spectroscopy, inductively coupled plasma-mass spectrometry, and gas chromatography-mass spectrometry were used to investigate the lipid profile and chemical composition of adipocere developed from decomposing tissue. The results suggest that adipocere is able to form in various soil types and that particular soil environments may accelerate its formation.     

大鼠脑损伤分级自由落体打击模型的建立

目的建立一个控制性与重复性好,并可分级的脑损伤动物模型。方法根据自由落体原理,使击锤从不同的高度下落,造成轻、中、重不同程度的大鼠脑损伤,肉眼、光镜观察损伤的程度。结果肉眼、光镜观察下出现可分级的病理学改变。轻度损伤组病理改变局限于大鼠大脑皮质浅层,中度损伤组病理改变可见于大脑皮质及深部白质内的基底核、海马、胼胝体、丘脑,重度损伤组病理改变除中度损伤累及部位外,还累及脑干。挫伤灶周围神经元变性、坏死范围和程度随损伤程度的加重而增大。各组内每只动物所受损伤程度一致。结论该模型制作出常见的闭合性颅脑加速伤损伤,致伤程度较一致,重复性好,可分级,是脑损伤实验研究较合适的动物模型。     

Fatal lung hemorrhage in complex pulmonary angiodysplasia in a case of mongolism

A case of sudden and unexpected death of a boy with Down-Syndrome is reported. Death was due to acute excessive haemorrhage from the lungs. There were no cardiac anomalies. Histology revealed in addition to mediahyperplasia, intimaproliferation and occlusions, multiple foci of anomalous ectatic blood vessels predominantly in the lungs, some of which ruptured and bled into adjacent airways. Evidence of previous less severe bleeding episodes was present. Further investigation showed a familial occurrence of the blood vessel anomaly.     

The temporal fate of drugs in decomposing porcine tissue

Drug levels in decomposed individuals are difficult to interpret. Concentrations of 16 drugs were monitored in tissues (blood, brain, liver, kidney, muscle, and soil) from decomposing pigs for 1 week. Pigs were divided into groups (n = 5) with each group receiving four drugs. Drug cocktails were prepared from pharmaceutical formulations. Intracardiac pentobarbital sacrifice was 4 h after dosing, with tissue collection at 4, 24, 48, 96, and 168 h postdosing. Samples were frozen until assay. Detection and quantitation of drugs were through solid phase extraction followed by gas chromatograph/mass spectrometer analysis. Brain and kidneys were not available after 48 h; liver and muscle persisted for 1 week. Concentration of drugs increased during decomposition. During 1 week of decomposition, muscle showed average levels increasing but concentrations in liver were increased many fold, compared to muscle. Attempting to interpret drug levels in decomposed bodies may lead to incorrect conclusions about cause and manner of death.     

Comparative characteristics of hydration distribution in various structures of the brain in the deceased of a severe cerebrocranial trauma

Hydration in the brain structures was analysed in 34 victims who had died of a severe craniocerebral trauma with pathological processes (hematoma, foci of brain crushing) of different location. Some of the patients had undergone open operations on the brain. Mosaic distribution of water was revealed in various structures of the brain where normohydration and dehydration occurred more often than hyperhydration.     

交通事故伤者智残评定的方法学研究

目的 探讨交通事故致颅脑外伤伤者智残评定的最佳方法。方法 采用4种智力评估方法对被鉴定人的智力和认知状况进行评估。结果 与智力迟滞诊断作为金标准相比较,事件相关电位P300评定结果呈显著正相关(125例,r(?)=0.952,P<0.01),成人智残评定量表结果呈显著正相关(129例,r(?)=0.963,P<0.01),韦氏成人智力测量总智商(IQ)评定结果呈无明显相关(4例,r(?)=0.099,P>0.05)。结论 根据智力迟滞诊断、事件相关电位测定P300、成人智残量表评定、韦氏成人智力测量等多种方法进行综合分析,可准确评定被鉴定者智残水平。如被评定者有伪装倾向,则不宜采用韦氏智力测量方法进行评估。     

The Application of Remote Sensing for Detecting Mass Graves: An Experimental Animal Case Study from Costa Rica*

Abstract: Detection of mass graves utilizing the hyperspectral information in airborne or satellite imagery is an untested application of remote sensing technology. We examined the in situ spectral reflectance of an experimental animal mass grave in a tropical moist forest environment and compared it to an identically constructed false grave which was refilled with soil, but contained no cattle carcasses over the course of a 16‐month period. The separability of the in situ reflectance spectra was examined with a combination of feature selection and five different nonparametric pattern classifiers. We also scaled up the analysis to examine the spectral signature of the same experimental mass grave from an air‐borne hyperspectral image collected 1 month following burial. Our results indicate that at both scales (in situ and airborne), the experimental grave had a spectral signature that was distinct and therefore detectable from the false grave. In addition, we observed that vegetation regeneration was severely inhibited over the mass grave containing cattle carcasses for up to a period of 16 months. This experimental study has demonstrated the real utility of airborne hyperspectral imagery for the detection of a relatively small mass grave (5 m²) within a specific climatic zone. Other climatic zones will require similar actualistic modeling studies, but it is clear that the applications of this technology provide the international community with both an early detection tool and a tool for ongoing monitoring.     

Cocaine‐Induced Intracerebral Hemorrhage in a Patient with Cerebral Amyloid Angiopathy*

Abstract: Intracerebral hemorrhage (ICH) is a well‐recognized complication of recreational cocaine use. The precise mechanism of the cocaine‐induced hemorrhagic event is unclear, although multiple factors have been implicated. We report a case of a 62‐year‐old woman who suffered left parieto‐occipital ICH with herniation and death, following a cocaine binge. Microscopic examination also revealed extensive cerebral amyloid angiopathy (CAA) in the vicinity of the hemorrhage. We additionally studied brain tissue in eight subjects between ages of 60 and 80 who were positive for cocaine metabolites at autopsy; of these, none had vascular amyloid‐β deposits by immunohistochemistry. Whereas we found no evidence that chronic cocaine use is a risk factor for CAA, given the age‐associated nature of CAA and the aging population using cocaine, CAA‐induced hemorrhage in the setting of cocaine use may be more common than recognized. This is the first reported case of CAA‐associated ICH precipitated by cocaine.     

Sequential monitoring of burials containing small pig cadavers using ground penetrating radar

Ground-penetrating radar (GPR) was used to monitor 12 pig burials in Florida, each of which contained a small pig cadaver. Six of the cadavers were buried in sand at a depth of 0.50-0.60 m, and the other six were buried in sand at a depth of 1.00-1.10 m to represent deep and shallow burials that are generally encountered in forensic scenarios. Four control excavations with no pig interment were also constructed as blank graves and monitored with GPR. The burials were monitored for durations of either 13 or 21 months, and were then excavated to correlate the decomposition state of the cadaver with the GPR imagery. Overall, this study demonstrated that it may be difficult to detect small cadavers buried in sand soon after they are skeletonized because the area surrounding the body, or the grave, may not provide a strong enough contrasting area to be detected by GPR when compared to that of the surrounding undisturbed soil. Also, depth of burial appears to influence grave detection because bodies that are buried at deeper depths may be detected for a longer period of time due to reduced decomposition rates.     

Sudden unexpected death in epilepsy: neuropathologic findings

Sudden unexpected death in epilepsy refers to sudden death of an individual with a clinical history of epilepsy, in whom a postmortem examination fails to uncover a gross anatomic, toxicologic, or environmental cause of death. Evidence of terminal seizure activity may not be present. One to two percent of natural deaths certified by the medicolegal death investigator are attributed to epilepsy. Detailed microscopic examination of the brain has increasingly afforded the identification of structural changes representative of epileptogenic foci. The authors present 70 cases of death attributed to sudden unexpected death in epilepsy. These cases were classified as follows: individuals who lacked a gross brain lesion, those who had a brain lesion demonstrable at autopsy, and those who lacked neuropathologic evaluation because of decomposition or because only an external examination was done. All of the subjects had a clinical history of seizures. The authors confirm that various microscopic findings, including neuronal clusters, increased perivascular oligodendroglia, gliosis, cystic gliotic lesions, decreased myelin, cerebellar Bergmann's gliosis, and folial atrophy, are present in a higher percentage of the brains of sudden unexpected death in epilepsy subjects than in the brains of age- and sex-matched control subjects.     

A clandestine burial in Costa Rica: prospection and excavation

Abstract:  This case report describes the search for a clandestine grave in Costa Rica for which the police sought the assistance of an archaeologist. An anonymous informant suggested that the victim had been kidnapped and murdered, placed in a shallow grave in the woods, then covered with lime and cement. A search of the area to detect conventional signs of burial (e.g., slumping, different plant growth) resulted in excavation of unrelated features of past disturbance. Different aspects of the grave including the deposition of cement powder over the body prevented its initial discovery. Improvisation of conventional archaeological excavation methods and use of police familiar with archaeological excavation resulted in the location of the grave and exhumation of the victim without loss of important contextual evidence that supported testimony on the cause of death. The taphonomic effects of high-lying ground water and lime in the tropical burial environment are briefly discussed. Recommendations such as the construction of a temporary sump to lower the ground water level in the grave during excavation are made to assist in similar investigations in the future.