Thomas Plattner

Charred body: Virtual autopsy with multi-slice Computed Tomography and Magnetic Resonance Imaging

The correct examination of a charred body is a forensic challenge. Examination, interpretation, and conclusion in respect to identification, vital reactions, toxicological analysis, and determining cause and manner of death are all more difficult than without burns. To evaluate what can be seen in the case of a charred body, we made an examination with the new radiological modalities of cross-section techniques, via multi-slice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI), prior to performing the classical forensic autopsy. In a charred body case of a single motor vehicle/fixed object collision with a post crash fire, the radiological methods of MSCT and MRI made it possible to document the injuries caused by burn as well as the forensic relevant vital reactions (air embolism and blood aspiration). In conclusion, we think postmortem imaging is a good forensic visualization tool with a great potential for the forensic documentation and examination of charred bodies.

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings

Based on only one objective and several subjective signs, the forensic classification of strangulation incidents concerning their life-threatening quality can be problematic. Reflecting that it is almost impossible to detect internal injuries of the neck with the standard forensic external examination, we examined 14 persons who have survived manual and ligature strangulation or forearm choke holds using MRI technique (1.5-T scanner). Two clinical radiologists evaluated the neck findings independently. The danger to life was evaluated based on the “classical” external findings alone and in addition to the radiological data. We observed hemorrhaging in the subcutaneous fatty tissue of the neck in ten cases. Other frequent findings were hemorrhages of the neck and larynx muscles, the lymph nodes, the pharynx, and larynx soft tissues. Based on the classical forensic strangulation findings with MRI, eight of the cases were declared as life-endangering incidents, four of them without the presence of petechial hemorrhage but with further signs of impaired brain function due to hypoxia. The accuracy of future forensic classification of the danger to life will probably be increased when it is based not only on one objective and several subjective signs but also on the evidence of inner neck injuries. However, further prospective studies including larger cohorts are necessary to clarify the value of the inner neck injuries in the forensic classification of surviving strangulation victims.

Elevated body core temperature in medico-legal investigation of violent death

Pathologically elevated body core temperature, measured at the death scene, is an important finding in medico-legal investigation of violent deaths. An abnormally high rectal temperature at any death scene may point to an underlying pathology, the influence of certain drugs or a hidden cerebral traumatism, and death by suffocation which would remain undetected without further medico-legal investigations. Furthermore, hyperthermia and fever, if unrecognized, may result in an erroneous forensic estimation of time since death in the early postmortem period by the “Henssge method.” By a retrospective study of 744 cases, the authors demonstrate that hyperthermia is a finding with an incidence of 10% of all cases of violent death. The main causes are: influence of drugs, malignant tumors, cerebral hypoxia as a result of suffocation, infections, and systemic inflammatory disorders. As a consequence it must be stated, that hyperthermia must be excluded in every medico-legal death scene investigation by a correct measurement of body core temperature and a comparison between the cooling rate of the body and the behavior of early postmortem changes, notably livor and rigor mortis.

Der außergewöhnliche Todesfall

The examination of a deceased person is an important duty for physicians. It comprises the certification of death, the certification of the identity of the deceased, a thorough examination of the body, an estimation of the moment of death and ends with the decision, if death was caused by a certain or possible violent cause in which case it must be reported to the authorities. Problems and pitfalls are discussed on the basis of practical case presentations.

Differenzierung von typischem und atypischem Erhängen

ZusammenfassungDie klassische Einteilung des Erhängens in typische und atypische Formen hat praktische rechtsmedizinische Bedeutung. Da das typische komplette Erhängen mit hinter dem Ohr befindlichem Knoten zu einer sofortigen Obstruktion der arteriellen Strombahn am Hals führt, sollten im Normalfall keine Stauungsblutungen bestehen. Im Gegensatz dazu sind von der typischen Stranglage abweichende Schlingenverläufe und inkomplettes Erhängen mit einem unvollständigen Verschluss der Karotiden verbunden, so dass in der Regel Stauungsbefunde zu beobachten sind. Jede Abweichung dieser Regeln sollte den Verdacht auf eine Fremdeinwirkung wecken und eingehende forensische und polizeiliche Abklärungen nach sich ziehen. Die Autoren präsentieren 2 von der Regel abweichende Fälle und schließen daraus, dass nicht allein die Knotenposition beachtet werden sollte. Vielmehr ist auf den Verlauf der Schlingenschenkel zu achten. Diese können beim atypischen Schlingenverlauf durch den Unterkiefer abgespreizt werden und die Karotistrombahn teilweise freigeben, so dass Stauungserscheinungen auftreten.AbstractHanging is traditionally subdivided into typical and atypical hanging based on the position of the noose around the victims’ neck. Cases where the knot is located behind the ear are referred to as typical hanging, whereas so-called atypical hanging comprises all forms of hanging where the knot is located in front of the ear or the body does not hang freely above the ground. This classification is of practical forensic significance. Since with a typical noose position and free hanging the cervical blood vessels are completely obstructed, no congestive petechial hemorrhages should be present, whereas in atypical forms petechiae are expected by an incomplete or unilateral obstruction of the carotid arteries. Any case deviating from this rule should raise the suspicion of possible intervention of a third party (i.e. throttling etc.) and lead to further forensic and criminalistic investigations. The authors present two exemplary cases, each representing an exception from the rule and try to give possible explanations. As a result, it can be stated that not the position of the knot alone is significant, but rather the course of the noose arms should be considered. In atypical hanging cases the latter may be stretched over the mandible thus freeing the carotid circulation and leading to reperfusion, which in turn may give rise to petechial hemorrhages.

External injuries to the neck after free fall from great height.

Falls from great height are suicidal in most cases. Any antecedent trauma that would indicate an involvement of a third party should, however, be excluded in each case. Herein lies the difficulty in such cases since injuries prior to the fall which could be of criminal nature may be masked by the impact injuries. Injuries on unexposed parts of the body should always raise the suspicion of an involvement of a third party. This applies especially for neck injuries. By a retrospective analysis of 132 cases of falls from great height, the authors conclude, however, that neck injuries may occur after free fall from great height on a flat surface without antecedent trauma.

überlebte Delikte gegen die körperliche und sexuelle integrität - : die Aufgaben des Notfallarztes

Die Untersuchung von lebenden Gewaltopfern sowie die Dokumentation von Verletzungen zahlt auch zu den Aufgaben des Notfallarztes. Seine Beobachtungen und die Befunddokumentation durch Fotografie, Zeichnungen und Befundbeschreibung stellen die Grundlage fur eine allfallige spatere strafrechtliche Untersuchung dar. Der Artikel behandelt die Aufgaben und das praktische Vorgehen des Arztes bei der Meldung und Befunddokumentation eines strafrechtlich relevanten Ereignisses im Allgemeinen und geht auf einige spezielle Situationen, die im notfallarztlichen Alltag eintreten konnen, ein.