Death from minor head trauma and alcohol

Sudden death in association with minor or otherwise insignificant head injury is increasingly being recognised in the forensic medical literature. While the exact mechanism of the cardiorespiratory arrest that appears to occur in these cases is unclear, a number of mechanisms have been postulated. Animal studies have provided evidence that alcohol can be associated with an increased period of apnoea following minor physical brain injury and cardiac changes have also been identified. The limited information in the community about the risk of alcohol in association with minor head injury causing death may be relevant in homicide cases where this issue is raised.     

Serious head and neck injury as a predictor of occupant position in fatal rollover crashes

Serious head and neck injuries are a common finding in fatalities associated with rollover crashes. In some fatal rollover crashes, particularly when ejection occurs, the determination of which occupant was driving at the time of the crash may be uncertain. In the present investigation, we describe the analysis of rollover crash data from the National Automotive Sampling System-Crashworthiness Data System for the years 1997 through 2007 in which we examined the relationship between a serious head and neck injury in an occupant and a specified degree of roof deformation at the occupant's seating position. We found 960 occupants who qualified for the analysis, with 142 deaths among the subjects. Using a ranked composite head and neck injury score (the HNISS) we found a strong relationship between HNISS and the degree of roof crush. As a result of the analysis, we arrived at a predictive model, in which each additional unit increase in HNISS equated to an increased odds of roof crush as follows: for ≥8cm of roof crush compared with <8cm by 4%, for ≥15cm of roof crush compared to <8cm by 6% and for ≥30cm of roof crush compared to <8cm by 11%. We describe two hypothetical scenarios in which the model could be applied to the real world investigation of occupant position in a rollover crash-related fatality.     

头部受力后导致脑肿胀并发TNH的相互关系

目的探讨头部受力后导致脑肿胀并发TNH的相互关系。方法采用福尔马林固定的91例大脑标本,根据脑的损伤特点分三组分别作冠、矢及水平状切面,肉眼观察。结果发现脑损伤致脑肿胀后产生的TNH有三种类型,即前位疝65例(71.4％),后位疝5例(5.5％),及单、双侧全疝21例(23.1％)。其中16例全疝仍见以前位疝最显著。结论头部受力后易在额颞部发生前位疝。TNH虽与受力部位、受力机制有一定关系,但仍与受力强度、伤后存活时间关系密切。     

Death in sauna

Bathing in sauna is common in Finland, where there are approximately 2 million saunas among the population of 5.2 million. In this paper, deaths occurring while in a sauna in 1990-2002 in Finland were studied by analyzing police and forensic autopsy reports, death certificates, and toxicological results. The annual rate of death occurring while in a sauna was less than 2 per 100,000 inhabitants. Close to half (51%) of the cases were determined to be natural deaths and exposure to heat was the cause of death in 25%. Overall, 50% of all cases were under the influence of alcohol. The main conclusion is that death in the sauna is a rare event even in Finland where the frequency of sauna bathing is high. The role of alcohol as a risk factor has grown. The prevention of these deaths should focus on less drinking of alcohol and avoid leaving a drunken bather alone in the sauna.     

Death due to unusual position of the body--an explanationfor the consequence of reduced venous reflux to the heart

The article describes the case of a 29-year-old woman who was found dead in her apartment on a bar stool with the body being maximally retroflected in the lumbar region, the head hanging down and the feet and hands barely touching the floor. On external inspection of the body the cuff-like distribution of hypostasis on the forearms and lower legs was consistent with the position in which the body was found. There were no signs of foreign intervention. At autopsy massive congestion was found in the internal organs as well as pulmonary and cerebral edema. In the ventral region of the lumbar intervertebral discs superficial hemorrhages were detected. The alcohol content was 3.40 per thousand in the blood and 4.43 per thousand in the urine. As the essential pathogenetic mechanisms responsible for death reduced venous reflux to the heart in combination with postural asphyxia and the influence of alcohol are discussed.     

Death notification

Family notification in sudden, unexpected, and violent death is a major responsibility of law enforcement, medical examiner, and coroner offices. This report reviews and discusses the process and procedures utilized in death notification and provides suggestions to accomplish this difficult task more effectively.     

Death notification

Death notification--informing the deceased's family of an unexpected death--is a singularly stressful task common to medical personnel, clergy, and police. We surveyed by questionnaire a group of 50 Los Angeles Police Department homicide detectives, 21 of whom were subsequently interviewed by telephone. The detectives stated that their initial apprehension stemmed from feeling unprepared. Identification with victims' families was common and compounded the stress. One prevalent worry concerned the possible reactions of the family upon hearing the news, especially the risk of a violent attack on the police officer. Several coping styles were recognized. Our findings suggest that the repetitive performance of this continuously stressful task may be a prominent and underappreciated contribution to occupational burnout.     

Traumatic Death in Ankylosing Spondylitis

Abstract: Ankylosing spondylitis (AS) is a chronic rheumatic disease that causes spinal rigidity with an increased risk of spinal fractures. We present a case report where a middle‐aged man, in apparent good health, died following a fall from his bike. Postmortem computed tomography (CT) showed several fractures in the cervical and thoracic spine, with displacement into the spinal canal as well as spinal changes consistent with AS. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fractures that were facilitated by spinal rigidity from AS. Further investigation into the medical records revealed that the decedent had previously been treated for AS. This case report illustrates the importance of obtaining a detailed medical history when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of CT in the evaluation of the mechanism and manner of death.     

Death in the dental chair

Death during dental anesthesia is relatively rare. Review of eight such cases which occurred in our county, including the different anesthetics used, revealed one apparent basic pattern that prevailed...a need for awareness that something might go wrong and recognition of the fact that it was going wrong.     

Death in a tetany attack

A case of latent tetany in a 24-year-old woman is reported. She had suffered several attacks of tetany in the last 12 years, mostly triggered by external stimuli. One evening, the woman was found dead in the hall of her flat beside the telephone with the upper limbs in a tetanic convulsive attitude. The attack of tetany was triggered by a telephone conversation. The parathyroid glands were normal. Day-old purulent myocarditis could be demonstrated in the left ventricle under the light microscope. The two possible pathogenetic explanations of the causal chain leading to death are discussed. It was astonishing that a clinical symptom (tetanic convulsion) was fixed in rigor mortis.     

Death in a fold-away bed

The term "death in abnormal body position" refers to deaths caused by a position-induced impairment of the vital functions of respiration and circulation. In the described case from the autopsy material of the Berlin Institute of Legal Medicine (CCM), the 82-year-old woman died in a folded up fold-away bed in a fixed head-down position. Death was caused by the combined effect of neck compression, traumatic asphyxia and head-down position.     

Death as a Penalty and the Fantasy of Instant Death

In this essay I take up the question of how death can be a penalty, given that each of us will eventually die. I argue that capital punishment in the United States rests on contradictory demands for painless death delivered humanely through pharmaceuticals and yet denies the accused the possibility of natural death. The death penalty must be at once humane and punishing. Analyzing what we mean by ‘botched’ executions, along with the language of the Supreme Court in upholding lethal injection as a humane application of the death penalty, I argue that the fantasy of instant death is at the heart of the tension between death as painless and death as penalty. In the end, I turn to Derrida’s Death Penalty Seminar Volume One, particularly his discussion of Kant’s defence of the capital punishment, and the pivotal role of time in his discussion. Finally, I suggest that the fantasies of instantaneous death and our technological mastery of it result in the fantasy of the ‘good’ punishing death.     

慎用死刑——刑事司法实践中死刑适用问题探讨

慎用死刑是刑事司法中一个十分重要的问题,慎用死刑必须正确掌握死刑的适用条件"罪行极其严重".如何判断"罪行极其严重"是一个难题,应该加强立法和司法的解释.与此同时,正确地适用"死刑缓期二年执行"是正确适用死刑的又一个重要课题.