Traumatic Brain Injury Due to Screwdriver Assaults: Literature Review and Case Report

Analysis of unique atypical screwdriver injuries

Fatalities caused by sharp and pointed instruments, especially screwdrivers, are not frequently observed in the United States. The shape of the screwdriver tip generally determines the resulting wounds that can range from linear, to rectangular or cross-shaped, often reflecting common screwdriver head shapes. Recognizing such patterns is crucial, as they can aid in identifying the potential weapon used in the crime. In the reported case, an adult male was found dead in his living room surrounded by a pool of blood, with multiple injuries. At autopsy, the pattern of penetration was consistent with that of a six-point star (Torx) screwdriver, which has never been reported as a deadly weapon in the literature before. A Torx screwdriver has a blunt head, resulting in hybrid injuries with both penetrating and blunt force features. Because of its rigid structure and narrow tip, a Torx screwdriver may forcefully penetrate the skin, soft tissues, and bone, causing severe injuries to the deep organs. The case highlights the importance for the forensic pathologist to examine and recognize atypical penetrating wounds for the identification and location of rare weapons. High-definition graphic documentation of the injuries allows thorough examination and comparison of injuries with potential weapons. When the weapon is not retrieved, detailed injury descriptions guide investigations toward searching for a screwdriver, improving the chances of identifying the weapon used to commit the crime.

Determining the manner of death in victims in drug-induced psychosis: a case of an atypical head stab wound

This case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement. Therefore, it also discusses the legal consequences that the case may have involved for the attending physicians in addition to the consequences for the suspected perpetrator. The report raises many issues encountered in the case in terms of the clinical treatment and forensic determination of the manner of death in cases of injuries caused by sharp instruments and highlights the importance of comprehensive evaluation of the circumstantial evidence together with the clinical or autopsy findings, since such evidence may sometimes be overlooked in clinical practice.

Management of Eight Hand Drill Nails Induced Penetrating Brain Injury

Background Penetrating brain injury (PBI) can be caused by several objects ranging from knives to chopsticks. However, an assault with hand drill while working in a factory is a peculiar accident. Because of its rarity and lack of standard protocol management, the management of PBI is complex.

Case Presentation We presented a case of a 26-year-old male with alleged history of insertion of eight nails from a hand drill machine from right side of head while working in a factory accompanied by loss of consciousness and history of vomiting. Computer tomography demonstrated that nails passed through the right parietal bone and reached up to contralateral hemisphere and posterior cranial fossa. Removal of nails and hematoma evacuation was done timely that led the patient to have a good postoperative recovery.

Conclusion In this case report, we discussed the successful management of a very rare penetrating head injury with a hand drill machine. The goal of this case report is to demonstrate the general management principles in PBI that can improve the patient outcome.

Patterned injuries from screwdrivers

A 40-year-old man was stabbed multiple times with a cross-tipped, Phillips head screwdriver with many of the puncture wounds characterized by a cruciate pattern consistently measuring approximately 5 × 5 mm corresponding to the shape of the weapon. Death was due to a single penetrating wound to the chest that had transfixed the aorta. This report characterizes the features of injuries that may be inflicted by Phillips head screwdrivers, contrasting this with injuries that may occur if the weapon is a flat or slotted head screwdriver. Given their ready availability, ease of handling, and sharpness, screwdrivers are surprisingly rarely used in fatal assaults.

An unusual patterned injury from homicidal craniocerebral impalement with a metal chair leg

A 26-year-old young man died shortly after he had suffered craniocerebral impalement from a metal chair leg during an affray at an airport bar. At autopsy a 25 mm diameter circular wound was present in the left parietal region with protruding brain tissue. Death was due to craniocerebral trauma from a penetrating injury to the head. Examination of the chair used in the assault showed a metal chair with smeared blood on the front right leg that matched the blood group of the decedent. The fatal wound had been inflicted by the assailant with the victim leaning forward while kneeling on the floor. The assault had produced an unusual circular patterned defect in the left parietal bone with dimensions corresponding to the chair leg. The location of the defect and the use of a chair leg were two very unusual features in this homicide.

Management of screwdriver-induced penetrating brain injury: a case report

Background

Penetrating brain injury (PBI) can be caused by several objects ranging from knives to chopsticks. However, an assault with long and electric screwdriver is a peculiar accident and is relatively rare. Because of its rarity, the treatments of such injury are complex and nonstandardized.

Case presentation

We presented a case of a 54-year-old female who was stabbed with a screwdriver in her head and accompanied by loss of consciousness for 1 h. Computer tomography (CT) demonstrated that the screwdriver passed through the right zygomatic bone to posterior cranial fossa. Early foreign body removal and hematoma evacuation were performed and the patient had a good postoperative recovery.

Conclusions

In this study, we discussed the clinical presentation and successful management of such a unique injury caused by a screwdriver. Our goal is to demonstrate certain general management principles which can improve patient outcomes.