Determination of the age of subdural hematomas from the concentration of hemoglobin

The photocolorimetric method was employed to measure hemoglobin levels in 46 traumatic subdural hematomas of different age. The data thus obtained were used to construct a logarithmic regression model for the determination of the age of subdural hematomas from the concentration of hemoglobin. The model allows to determine injury time points and intervals at any desired level of confidence probability. The fraction of dispersion of hematoma age values attributable to regression was estimated at 41% which accounts for 74.7% of the maximally possible magnitude. Results of the study can be used in practical work of a forensic-medical experts.     

The epidemiological characteristics of fatal subdural hematomas in forensic medical practice

A retrospective analysis of subdural hematomas is carried out: 493 in subjects dead from mechanical injuries (from files of forensic medical morgues in Tver', 1992-1994), and 37 cases with chronic subdural hematomas (from files of forensic medical morgues No. 2 and 6 in Moscow, 1995-1997). Age and sex of victims, time and circumstances of injuries, topographic and morphological features of subdural hemorrhages and their relation to concomitant injuries, and presence of ethyl alcohol in the organism are studied. The data on chronic subdural hematomas are presented. The authors emphasize the need in forensic medical studies of this condition.     

Modern aspects of forensic medical diagnostics of the craniocerebral injury

The authors report the results of the investigations of craniocerebral injuries (CCI) including crystallographic studies of brain liquor obtained after the injury and non-traumatic pathological processes. The additional forensic medical criteria for the severity of craniocerebral injuries have been developed and the objective signs of CCI determined to be used for diagnostic purposes in the cases with concomitant diseases and also in the subjects of advanced and declining age. The diagnostic methods for the elucidation of the nature of chronic subdural hematomas and the estimation of the time of their formation have been improved.     

Hypernatremia and subdural hematoma in the pediatric age group: is there a causal relationship?

Several researchers in the 1950's proposed that hypernatremia causes water to leave brain cells, shrinking the brain, thus tearing the bridging veins and resulting in subdural hematomas. Although the old literature suggests mechanisms linking the two in a cause and effect relationship, there is controversy as to whether hypernatremia leads to subdural bleeding or whether the reverse is true. This issue is important for forensic pathologists who must distinguish natural disease from trauma. An etiologic link between hypernatremia and subdural hematomas was suggested recently, and was proposed originally before Kempe's 1962 paper "The Battered Child Syndrome" which widely disseminated the concepts of child physical abuse, and of subdural bleeding resulting from non-accidental injury. Our study is a multifaceted investigation of infants which includes: a literature review, retrospective chart reviews of both living and deceased hypernatremic infants, a retrospective review of infants hospitalized with subdural hematoma, and a prospective collection of head injured, hypernatremic children. We conclude that hypernatremia, if present in association with subdural hemorrhage, is most likely secondary to intracranial pathology, and that hypernatremia often develops in critically ill infants suffering from a variety of medical conditions.     

The morphological characteristics of chronic subdural hematomas

Preparations of chronic subdural hematomas (CSH) obtained during surgery from 29 patients aged 19-50 years are studied. Histological sections were stained with hematoxylin-eosin after van Gieson. Morphological criteria of CSH variants are defined, permitting forensic medical experts to make well-based conclusions on the nature (traumatic or not) of CSH (two types of capsules) and the time when it occurred.     

Persistent Retinal Iron in Abusive Head Trauma

Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5‐month‐old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation. Ophthalmopathological investigation showed atrophy of the retina and optic nerve and hemosiderin deposition in both eyes. Retinal hemosiderin deposition is currently generally assumed to disappear within 6–8 weeks after the occurrence of hemorrhage in AHT. This case report describes an infant with bilateral retinal hemosiderin depositions due to hemorrhages sustained from AHT occurring 32 months prior to death. Implications of this finding for the interpretation of retinal hemosiderin depositions in AHT are discussed.     

Problems in biomechanics of life-time intracranial injuries

Discusses the impact of kinetic energy and number of head movements during falling from a standing posture on one's back for various variants of falling on the formation of subdural hematomas, subarachnoidal hemorrhages, and brain concussions in the areas of the stroke, contralateral to the stroke, and intermediate. Discloses the correlations between the area and volume of injury and changes in energy parameters of stroke impact. Demonstrates the relationship between the severity of atherosclerotic involvement of the vessels and the volume and type of intracranial injury.     

Quantifying Macrophages and Hemosiderin in Pediatric Dura Mater,

Determining the age of a subdural hematoma at autopsy is of great interest for medicolegal purposes. The appearance of pigment‐laden macrophages is often referenced as evidence that the subdural hematoma is 3–4 days old. However, understanding the significance of macrophages and hemosiderin requires understanding the histology of infant dura. Samples of grossly unremarkable dura taken from 17 pediatric autopsies were identified and histologically confirmed to lack subdural neomembrane. CD68 immunostaining and Prussian blue staining was performed. The CD68‐positive cells per high‐power field were quantified, and the presence of iron‐containing cells was recorded. CD68‐positive cells were present in all cases, even in the dural border layer. Iron‐containing cells were identified in 59% of cases, and in the dural border layer in 29%. Therefore, CD68‐positive and iron‐containing cells can be present in pediatric dura without neomembrane or macroscopic subdural hemorrhage, and this requires consideration when estimating the age of a subdural hematoma.     

Age estimation from quantitation of features of "chest plate" X-rays

This study presents a method for estimating the age at death from the quantitation of roentgenologic features of X-ray films of chest plates obtained during routine autopsies. Multiple linear regression analysis allows estimation of coefficients of regression of features on known age-at-death individuals. The regression equation can be used in turn for age estimation of an unknown age-at-death individual. The accuracy of age estimation is about +/- 8.4 years (standard error) which is in the range of previously published macroscopic methods, though the present method is much faster and simpler.     

Experimental Study of Bite Mark Injuries by Digital Analysis

Abstract: This study was based on a morphometric analysis of bite marks starting from the quantitative definition of the anterior teeth by the geometric acquisition of the “injuries,” using bite marks impressed on pig skin and plastic. Each mark was photographed and acquired. A dedicated program automatically supplied the values of the shape factors and the areas of the pattern geometric figures. The values obtained for the homologous samples were compared to the heterologous values. Statistical comparison was made of the sets by linear regression, determining the correlation coefficient and the determination coefficient for each value. Results showed only 4.8% and 2% of overlap between homologous and heterologous values. This study was carried out in attempting to quantitatively define the anterior teeth of the human dentition and the procedure described and the results obtained support the advantage of morphometric studies and computer‐aided programs in this study of bite marks.     

Multiple regression models for age estimation by assessment of morphologic dental changes according to teeth source

The aims of this study were twofold: (1). to measure parameters that contribute significantly to estimates of dental age, using a combination of classic methods and a computer-assisted image analysis procedure to avoid the bias inherent in observer subjectivity; and (2). to develop new mathematical regression models for age prediction according to postmortem interval. Two different populations were studied. Forty-three permanent teeth (Group I), extracted for valid clinical reasons, were taken from patients 25-79 years of age. The other population group (Group II) was composed of 37 healthy erupted permanent teeth obtained from human skeletal remains (age 22-82 years) with a postmortem interval ranging from 21 to 37 years. Morphologic age-related changes were investigated by measuring variables on intact and half-sectioned teeth. Multiple regression analyses were performed with age as the dependent variable for each sample source. In fresh extracted teeth, the variables that made the greatest contributions to predictions of age were dental attrition, dentin color, and translucency width, the latter measured with a computer-assisted image analysis method. In teeth from human skeletal remains, the variables that made the greatest contributions to age calculation were cementum apposition, pulp length measured by computer-assisted image analysis, dental attrition, root translucency, and dental color. We conclude by recommending different regression models to calculate age depending on the postmortem interval.     

Morphometric analysis of third molar root development by an experimental method using digital orthopantomographs

Abstract:  The aim of the study was to conduct a morphometric analysis of the root development of the third molar, with the purpose of overcoming the limits of an exclusively morphological analysis. The study was divided in two phases. The first one was the verification of the existence of a constant crown-root (C/R) ratio on a sample of 100 third molars, characterized by a complete root development. The value obtained was used in the second phase to predict the final root's length, knowing the crown height. So we have calculated, on a sample of 322 third molars with developing roots, the final ratios between incomplete roots and complete roots. Statistical analysis was then made with 90%, 95%, and 99% confidence intervals. The results showed a significant difference according to the age of the subject and the limit values, lower and upper, for subjects aged 16 and 17 years versus those aged 18 and 19. For each analysis, the width of the class of tolerance and other statistical indicators were calculated. The results we obtained support the advantage of a morphometric study as opposed to an exclusively morphological study, but all the techniques used to determine the age of a living subject can provide only indications of the biological age, but no certainties as regards chronological age.     

Testing Theory and the Analysis of Time Series Data

Although the relationship between unemployment and crime has been a longstanding interest in criminology, there is little agreement about appropriate models for analyzing this relationship. David Greenberg's (this issue) discussion highlights two issues that raise questions about recent research on the unemployment–crime relationship. First, he extends the work of Hale and Sabbagh (1991) and argues that cointegration methods should be used instead of first-differenced regression models to analyze unemployment and crime time series data. Second, he argues that previous attempts to test his strain theory linking unemployment to the age distribution of crime rely on flawed hypotheses, inappropriate data, and faulty measurement. In this paper, I address both of Greenberg's claims. I begin with a discussion of the relative utility of cointegration analysis and of first-differenced regression models for the analysis of the unemployment–crime relationship, focusing on the link between theory and statistical model. I then discuss the possibility of ever testing and falsifying Greenberg's strain theory.     

An appraisal of plastic reconstruction of the external nose

The association between the morphometric dimensions of the external nose, including the thickness of the soft tissues, and various craniometric measurements has been examined on a sample of lateral radiographs of 154 males and 199 females from Vienna, Austria. In addition, the influence of age on morphometric dimensions and the soft tissue cover was tested. Multiple stepwise regression analysis revealed that nasal height and nasal length are best predicted by the dimensions of the skull, whereas nasal depth and the thickness of the soft tissues is greatly influenced by age. In males, over 50% of the variance of nasal height and nasal length were accounted for by the height of the bony nose and the prominence of the ossa nasalia, and in females it was about 40%. Although the thickness of the soft tissue is dependent on exogenous factors, such as nutrition, mimicry, and so forth, the dimensions of the bony nose apparently also influence the skin depths to some extent. High and prominent noses were found to have a thinner layer of soft tissue over the nasal bones than short and less prominent ones. It thus seems as if there is a tendency of the soft tissue cover to adjust to disharmonies of the bony profile.     

A comparison of post-mortem ethanol levels obtained from blood and subdural specimens

Post-mortem subdural ethanol levels have been proposed as a useful test in certain forensic cases involving head trauma, particularly when the time interval from injury to death may have caused a lowering of the blood ethanol concentration to insignificant or undetectable levels. This study of 75 autopsied persons from whom both blood and subdural ethanol levels were obtained, shows the usefulness of the subdural ethanol level, especially where there is a prolonged or unknown post-traumatic time interval. Use of such a test is recommended in these situations.     

Extractable iron in experimental hematomas

The extractable iron and total iron were determined in experimental, subcutaneous hematomas (5 ml blood) of rats after different periods of vital time. The extractable iron was determined from homogenate extract obtained after 24-h incubation with concentrated HCl diluted 1:3 and protein precipitation. For the determination of total iron, the specimens were wet-ashed. The same iron determinations were also made for the corresponding control specimens of the subcutaneous tissue. Extractable iron started to rise over the control values in 2-day-old hematomas, being about 5 times higher after 3 days, about 15 times higher after 7 days, and about 20 times higher after 14 days. The ratio of extractable iron and total iron expressed as percentages was about 1% in 1-h and in 1-day-old hematomas, about 20% in 3-day-old hematomas, about 50% in 7-day-old hematomas, and about 65% in 14-day-old or older hematomas. The effect of autolysis for 3 days at room temperature was studied on 1-h-old hematomas. Extractable iron values were slightly higher in the autolyzed specimens, but the difference was statistically insignificant as compared to specimens taken immediately after death.     

Assessment of histomorphological features of the sternal end of the fourth rib for age estimation in Koreans

The aim of this study was to assess the histomorphological features of the fourth rib and to develop age-predicting equations for Koreans. Sixty-four rib samples (36 males and 28 females) obtained from forensic cases were used for developing equations. Two thin sections (<100-microm thick) per sample were prepared by manual grinding. Multivariate analysis of covariance revealed statistically significant differences in age-adjusted histomorphological variables between sexes. Using stepwise regression analysis, osteon population density and average osteon area were correlated with unknown sex (r2 = 0.826), and sex plus two histomorphological variables provided the best results for an age-predicting equation given the assumption of knowing the sex of a specimen (r2 = 0.839). Average Haversian canal area had little influence on age estimation for male or female samples, and relative cortical area was not significantly related to age for any specimen.     

基于数据挖掘实现成人喉软骨和舌骨CT图像重组的年龄推断

目的 运用数据挖掘技术探索喉软骨和舌骨CT图像重组用于成人年龄推断的可行性.方法 收集413例颈部薄层CT图像,样本年龄范围18～<80岁,将样本随机分为测试集和训练集.参照TURK等的分级方法,对所有样本进行全方位综合阅片分级,将甲状软骨骨化过程分为6级,环状软骨骨化过程分为5级,舌骨大角和舌骨体的骨性结合分为3级....