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American Journal of Forensic Medicine and Pathology

Leonardo Pacheco Roquero, Sandra Camelo-Piragua, Carl Schmidt
Cerebral air embolism is a recognized life-threatening complication, sometimes iatrogenic. Its timely diagnosis is essential because it can result in neurologic deficits or death. We report a case of a 58-year-old man who died from cerebral air embolism diagnosed by nonenhanced computed tomography scan of the head after a cardiac bypass surgery with Biventricular Assist Device and multiple vascular line placements. Autopsy revealed extensive subcutaneous emphysema, intravascular and perivascular air bubbles in the central nervous system and associated cerebral and cerebellar hemorrhagic infarction...
October 19, 2016: American Journal of Forensic Medicine and Pathology
Taner Daş, Aytül Sargan, Gülhan Yağmur, Muzaffer Yildirim, Cumhur Selçuk Topal, Ahmet Selçuk Gürler, Hizir Asliyüksek, Murat Nihat Arslan, Rifat Özdemirel
Lower respiratory infections are commonly due to viruses and are the third largest cause of death. Respiratory tract viruses have a tendency to target the specific regions in the lung and can harm the host via direct effect of the virus and the host's inflammatory response. In this study, relationships between morphologic changes in the lung and the viral agent type isolated in the lung by the polymerase chain reaction technique were investigated. This study was performed retrospectively at 113 autopsy cases in the Council of Forensic Medicine in Istanbul...
October 7, 2016: American Journal of Forensic Medicine and Pathology
Jacob Joseph Moar, Lawrence Hill, Michael Stewart
Although cobra envenomation continues to pose a threat to life and therefore constitutes a major cause of death in Africa, India, and Sri Lanka, the forensic pathology reports are not always histologically well documented or illustrated. The reports in the literature, although providing graphic evidence of the macroscopic appearances of the bite and its ensuing tissue necrosis, should the victim survive, often do not illustrate the histopathological findings to a sufficient degree. We present an unusual case of fatal envenomation by a rinkhals (Hemachatus haemachatus) in which the victim had been bitten a second time after a previous rinkhals' bite...
September 21, 2016: American Journal of Forensic Medicine and Pathology
Lidia Capotosto, Giulia Elena, Francesco Massoni, Simone De Sio, Aldo Carnevale, Serafino Ricci, Antonio Vitarelli
In the past, cardiac tumors were a just clinical curiosity and the prognosis was poor. Surgical management became possible after the advent of cardiopulmonary bypass, and more recently, preoperative diagnosis was greatly improved by the development of echocardiography, computed tomography, and magnetic resonance imaging. The value of echocardiography for diagnosing cardiac mass lesions has become well established. Numerous advances have occurred in the last 5 decades, and the evolution of echocardiography involves the development of its many modalities...
September 8, 2016: American Journal of Forensic Medicine and Pathology
Magdaleni Bellis, Jayantha Herath, Michael S Pollanen
We report a retrospective review of fatal acute epiglottitis cases in adults in the province of Ontario, Canada, between 2001 and 2014. Information on demographics, clinical history, gross, microscopic, and laboratory findings were collected and analyzed. Eleven cases, predominantly male (73%), with a mean age of 50 years were identified. Common presenting symptoms included sore throat, dysphagia, and low-grade fever. The predominant postmortem findings included hyperemia and edema of the epiglottis and aryepiglottic folds...
September 8, 2016: American Journal of Forensic Medicine and Pathology
Elisa Cerutti, Laura Spagnoli, Nadezhda Araujo, Daniele Gibelli, Debora Mazzarelli, Cristina Cattaneo
One of the main issues in forensic anthropology consists of the identification of signs of trauma in skeletal remains, including sharp-force injuries. So far, several studies have been performed to assess differences between injuries caused by different instruments, not, however, through light microscopy.In this study, 152 sharp-force injuries were performed by 5 different tools through 2 different orientations on 2 humeral diaphyses and were analyzed by stereo and light microscopy to assess possible morphological differences...
August 31, 2016: American Journal of Forensic Medicine and Pathology
Jack Garland, Rexson Tse, Allan D Cala
Sepsis remains a difficult diagnosis at autopsy. With respect to meningococcal sepsis, a timely and definite diagnosis is critical because it requires public health department notification and the administration of prophylactic antibiotics to potential close contacts. A previous case series, in which both blood and cerebrospinal fluid were unavailable, suggested vitreous humor polymerase chain reaction might be a useful test in diagnosing meningococcal sepsis. We describe a fatal case of meningococcal sepsis where Neisseria meningitidis was detected in both vitreous humor and blood polymerase chain reaction, in addition to positive blood cultures...
August 31, 2016: American Journal of Forensic Medicine and Pathology
Ralph Neumann, Janine Abu-Isa, Stamatios Stamou, Dominic Gascho, Michael J Thali, Lars C Ebert, Patricia Mildred Flach
The purpose of this study was to investigate papilledema (PA) as a diagnostic criterion for the presence of antemortem or agonal cerebral edema despite normal postmortem brain swelling on postmortem magnetic resonance imaging (PMMR) in comparison with conventional autopsy.One hundred subjects with head PMMR and autopsy were included in this study. The sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and accuracies were calculated in terms of the PA, PMMR, and cerebral edema on autopsy...
August 26, 2016: American Journal of Forensic Medicine and Pathology
Géraldine Maujean, Pierrick Vacher, Jacques Bagur, Tiphaine Guinet, Daniel Malicier
Post mortem changes due to putrefaction sometimes make people wrongly consider the autopsy of a decomposed body as unrewarding. A 5-year retrospective study was conducted and included all types of decomposed body subject to medicolegal autopsy, excluding bone remains and charred bodies. Sociodemographic, medical, and forensic data were collected. In the 350 cases included, most were socially isolated mature males discovered at home. The cause of death was determined in 80% of cases, and the manner of death in 86...
August 26, 2016: American Journal of Forensic Medicine and Pathology
Pavlos Pavlidis, Maria-Valeria Karakasi, Theodossios A Birbilis
Penetrating head injuries due to the use of screwdrivers as wounding agents in acts of interpersonal violence seldom occur. The aim of this article is to update and summarize the relevant literature on penetrating craniocerebral screwdriver stab wounds and to report a new case of screwdriver assault. A number of studies were reviewed to investigate the incidence, distribution, common findings, mechanism of injury, differential diagnostic criteria, complications, treatment, and prognosis of craniocerebral screwdriver stab injuries...
August 26, 2016: American Journal of Forensic Medicine and Pathology
Akihito Usui, Yusuke Kawasumi, Yuya Ishizuka, Yoshiyuki Hosokai, Tomoya Ikeda, Haruo Saito, Masato Funayama
This case report describes a woman who developed fatal gastric dilatation after binge eating. She called an ambulance because of stomach pain. When she arrived at the hospital, she did not look seriously ill. However, she rapidly became unconscious and collapsed immediately after she was laid on the examination table in a supine position. Postmortem chest x-ray and computed tomography showed right shift of the mediastinum and raised left diaphragm caused by massive gastric distension. Computed tomography showed no visible inferior vena cava...
August 26, 2016: American Journal of Forensic Medicine and Pathology
Leigh Hlavaty, William Kasper, LokMan Sung
The constellation of injuries observed in hangings is a subject receiving frequent review in forensic pathology literature. Whereas recent studies have reported high concordance between hangings and internal findings such as strap muscle hemorrhages and hyoid bone and thyroid cartilage fractures, a 2-part study examining autopsied suicidal hangings over a 9-year period at the Wayne County Medical Examiner's Office produced markedly differing results. Retrospectively and prospectively, external and internal autopsy observations were correlated with factors such as age, sex, body height, body mass index, ligature, and height of suspension...
August 26, 2016: American Journal of Forensic Medicine and Pathology
Rajpal Singh Punia, Reetu Kundu, Dasari Harish
Extralymphatic filarial disease has varied clinical manifestations and is largely underestimated worldwide. We report an autopsy case of extralymphatic filarial disease with coronary and pulmonary circulations being involved and causing sudden death. Such an isolated event is, perhaps, rare and has not been reported so far to the best of our knowledge. Microfilaremia on autopsy may be easily missed or overlooked due to unawareness. The present report emphasizes the importance of extensive careful scrutiny of autopsy sections...
August 9, 2016: American Journal of Forensic Medicine and Pathology
Xiulu Ruan, Dawn D Tiemann, Alan David Kaye
No abstract text is available yet for this article.
August 4, 2016: American Journal of Forensic Medicine and Pathology
Stamatios Stamou, Dominic Gascho, Sebastian Eggert, Florian Berger, Michael J Thali, Patricia M Flach
Forensic autopsy is still the criterion standard in legal investigations. Currently, notable transformation is occurring because postmortem imaging is being increasingly endorsed. This article highlights the effectiveness of postmortem computed tomography angiography by using a new contrast medium mixture as a solitary tool to define the cause and manner of death in a ruptured cerebral aneurysm case. Based on the imaging results, autopsy was not mandated and the case was closed.
August 3, 2016: American Journal of Forensic Medicine and Pathology
Sabine Franckenberg, Thomas Binder, Stephan Bolliger, Michael J Thali, Steffen G Ross
Cross-sectional imaging, such as computed tomography, has been increasingly implemented in both historic and recent postmortem forensic investigations. It aids in determining cause and manner of death as well as in correlating injuries to possible weapons. This study illuminates the feasibility of reconstructing guns in computed tomography and gives a distinct overview of historic and recent Swiss Army guns.
September 2016: American Journal of Forensic Medicine and Pathology
Audrey-Ann Marie Evetts, Michael J Shkrum, Elena Tugaleva
It is common practice in pediatric autopsies to compare the body and organ measurements of the deceased child against the existing reference data. Although a number of resources are available, many are outdated and have significant limitations. The goal of this study was to assess the reference sources currently used by the Ontario pathologists in pediatric autopsies. A survey of 14 Ontario pathologists, who do coroners' pediatric autopsies, identified 20 publications commonly referenced for body and organ measurements...
September 2016: American Journal of Forensic Medicine and Pathology
José Luís Alves, João Gonçalo Santiago, Guerreiro Costa, Anabela Mota Pinto
Subdural hematomas are a frequent and highly heterogeneous traumatic disorder, with significant clinical and socioeconomic consequences. In clinical and medicolegal practice, subdural hematomas are classified according to its apparent age, which significantly influences its intrinsic pathogenic behavior, forensic implications, clinical management, and outcome. Although practical, this empirical classification is somewhat arbitrary and scarcely informative, considering the remarkable heterogeneity of this entity...
September 2016: American Journal of Forensic Medicine and Pathology
Junchao Zhang, Yibo Yan, Yiqun Chen, Sizhe Huang, Liang Liu
Basilar fractures are one of the consequences of craniocerebral injury, which is serious enough to cause death. Legal examiners often pay attention to basilar fractures at autopsy and analyze the relationship between them and death. It is noteworthy whether the fracture is premortem or postmortem. Here, we describe a rarely reported case of basilar fracture due to freezing. In this case, a 30-year-old man was frozen (-18°C) for 6 months after death. At autopsy, external examination showed no trauma. However, on internal examination, there was a basilar fracture which caused controversy but turned out to be a postmortem injury...
September 2016: American Journal of Forensic Medicine and Pathology
Ahmet Selçuk Gürler, Taner Daş, Gökhan Gitmiş, Nedim Apaydin, Erdoğan Kara, Rifat Özgür Özdemirel, Safa Çelik, Emel Özdeş, Yiğit Sezer
A lithopedion is a rare complication of pregnancy that occurs when a fetus in an intraabdominal location dies, and it is too large to be reabsorbed by the body. The case was an 87-year-old woman, and she was transferred to the morgue department in April 2014 to determine the cause of death. During autopsy, an intraabdominally located calcified dead fetus and a 12-cm diameter calcified cyst in the right ovary were incidentally detected. It was aged 25 to 29 weeks (according to femur and humerus measurements) with a size of 12...
September 2016: American Journal of Forensic Medicine and Pathology
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