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Committing Suicide With Handgun Wounds in the Head Using a Defective Firearm: About 2 Unusual Autopsy Cases. Am J Forensic Med Pathol 2020; 41:124-127. [PMID: 32205489 DOI: 10.1097/paf.0000000000000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report 2 unusual autopsy cases with head handgun wounds using defective firearms in a suicidal context. In the first case, a 78-year-old man was found hanged from a tree, with a Lefaucheux revolver lying on the tree. In the right temporal region, there was an entrance wound with a bullet still in place, responsible for a mild cerebral contusion, without bone defect. The main cause of death was hanging. In the second case, a 60-year-old man died at home after shooting himself in the head several times with a 22-long rifle revolver. The autopsy showed 13 entrance wounds on the scalp. Most of the bullets remained along the skull vault. In each of 2 cases, the manner of death, the feasibility of suicidal gesture, and the consequences of a brain injury on the time to the occurrence of incapacity were questioned. These unusual autopsy cases underline how important it is to take into account the defective nature of firearms.
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Radiological investigation of gunshot wounds: a systematic review of published evidence. Int J Legal Med 2019; 133:1149-1158. [DOI: 10.1007/s00414-019-02071-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
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Medicolegal Investigations in Cases of Double Suicidal Gunshots to the Head Using 2 Different Handguns: A Report of an Unusual Case. Am J Forensic Med Pathol 2019; 40:266-268. [PMID: 31033489 DOI: 10.1097/paf.0000000000000487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Suicides committed by firing 2 gunshots to the head are rare events and pose a significant challenge for coroners and forensic pathologists. The evaluation of the victim's ability to fire 2 shots simultaneously, or to act after a first gunshot, is crucial for the reconstruction of the death scene and to differentiate between homicide and suicide. We report an unusual case of suicide involving 2 gunshot wounds to the head. The medicolegal investigations hypothesized that the victim had either fired 2 shots near simultaneously or he suffered from rapid incapacitation after the first gunshot but was still able to fire a second consecutive and fatal shot to the head. This article focuses on the diagnostic difficulties involved, together with analysis of the death scene and autopsy findings, in cases where the courts demand confirmation that a double gunshot to the head is in fact a case of suicide.
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Hasegawa I, Shimizu A, Saito A, Suzuki H, Vogel H, Püschel K, Heinemann A. Evaluation of post-mortem lateral cerebral ventricle changes using sequential scans during post-mortem computed tomography. Int J Legal Med 2016; 130:1323-8. [PMID: 27048214 PMCID: PMC4976059 DOI: 10.1007/s00414-016-1327-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/03/2016] [Indexed: 11/21/2022]
Abstract
In the present study, we evaluated post-mortem lateral cerebral ventricle (LCV) changes using computed tomography (CT). Subsequent periodical CT scans termed “sequential scans” were obtained for three cadavers. The first scan was performed immediately after the body was transferred from the emergency room to the institute of legal medicine. Sequential scans were obtained and evaluated for 24 h at maximum. The time of death had been determined in the emergency room. The sequential scans enabled us to observe periodical post-mortem changes in CT images. The series of continuous LCV images obtained up to 24 h (two cases)/16 h (1 case) after death was evaluated. The average Hounsfield units (HU) within the LCVs progressively increased, and LCV volume progressively decreased over time. The HU in the cerebrospinal fluid (CSF) increased at an individual rate proportional to the post-mortem interval (PMI). Thus, an early longitudinal radiodensity change in the CSF could be potential indicator of post-mortem interval (PMI). Sequential imaging scans reveal post-mortem changes in the CSF space which may reflect post-mortem brain alterations. Further studies are needed to evaluate the proposed CSF change markers in correlation with other validated PMI indicators.
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Affiliation(s)
- Iwao Hasegawa
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg, 22529, Germany. .,Department of Forensic Medicine, School of Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan. .,Tokyo Medical Examiner's Office, Otsuka 4-21-18, Bunkyo, Tokyo, 112-0012, Japan.
| | - Akinobu Shimizu
- Institute of Engineering, Tokyo University of Agriculture and Technology, Naka-cho 2-24-16, Koganei, Tokyo, 184-0012, Japan
| | - Atsushi Saito
- Institute of Engineering, Tokyo University of Agriculture and Technology, Naka-cho 2-24-16, Koganei, Tokyo, 184-0012, Japan
| | - Hideto Suzuki
- Tokyo Medical Examiner's Office, Otsuka 4-21-18, Bunkyo, Tokyo, 112-0012, Japan
| | - Hermann Vogel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg, 22529, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg, 22529, Germany
| | - Axel Heinemann
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg, 22529, Germany
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Three rounds as "tandem bullets": unusual findings in a case of a suicidal gunshot to the head. Forensic Sci Med Pathol 2014; 10:613-8. [PMID: 25091600 DOI: 10.1007/s12024-014-9591-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2014] [Indexed: 10/24/2022]
Abstract
We report an unusual case of suicide in which three 7.65 caliber projectiles were found in the single gunshot wound to the head of a 53-year-old man. Based on data collected at the death scene, CT scan, autopsy findings, and ballistics analysis, the events were reconstructed as follows: two 7.65 mm rounds had already been fired from the 9 mm Makarov pistol the subject was using but, being a smaller caliber, the cartridges had slipped forward and lodged within the barrel. When a third 7.65 mm cartridge was chambered and the gun fired for the third time, the nose of the last bullet hit the lodged bullets and all three rounds were propelled out of the muzzle in tandem as a single shot. Ballistic investigations confirmed that the kinetic energy of the three tandem bullets would have been sufficient to perforate the skull. In cases of gunshot wounds where the manner of death is unclear, a number of well-described circumstantial parameters, such as an atypical anatomical location of the gunshot, unusual firearm, or ammunition, as well as ambiguous autopsy findings, can raise doubts about the manner of death. In very rare cases, despite a single entrance wound, two or more bullets are recovered from the body, fired by the same weapon at the same time (the so-called "tandem bullet" phenomenon). Injuries by "tandem bullets" have crucial implications in gunshot deaths because of the mismatch between the number of entrance and exit wounds and the number of bullets found in or near the body.
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Hasegawa I, Heinemann A, Tzikas A, Vogel H, Püschel K. Criminal gunshot wound and iatrogenic tension pneumothorax detected by post-mortem computed tomography. Leg Med (Tokyo) 2014; 16:154-6. [PMID: 24630902 DOI: 10.1016/j.legalmed.2014.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 01/23/2023]
Abstract
Post-mortem imaging at autopsy is gradually increasing in popularity among forensic practitioners. The objective of the present paper was to demonstrate that it is essential to survey the cadaver using computed tomography (CT) before autopsy. This case report presents an iatrogenic tension pneumothorax caused by left subclavian vein puncture undertaken during treatment for a gunshot-related wound. The victim, a 64-year-old woman, was shot by her husband at home, and transferred to the hospital emergency unit. Before surgical procedures were carried out, left subclavian vein puncture was performed; however, during the operation, the victim experienced sudden cardiac arrest. Subsequent intensive resuscitation was unsuccessful. The clinical cause of death was recorded as traumatic shock caused by the gunshot injury. However, before the legal autopsy took place, CT clarified the existence of tension pneumothorax not on the same side as the gunshot wound, but on the side of the iatrogenic subclavian vein puncture. Because of this information gained prior to legal dissection, a typical dissection procedure for tension pneumothorax could be performed. Post-mortem imaging prior to regular dissection is essential as an adjunct diagnostic tool.
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Affiliation(s)
- Iwao Hasegawa
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany.
| | - Axel Heinemann
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Antonios Tzikas
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Hermann Vogel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
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Assisted suicide and killing of a household pet: pre-autopsy post-mortem imaging of a victim and a dog. Forensic Sci Med Pathol 2013; 10:122-5. [DOI: 10.1007/s12024-013-9498-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 10/26/2022]
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