Unexplained fall and fatal head injury: Forensic implications of neurocysticercosis.

Abstract

Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system (CNS) by the larval stage of Taenia solium. We present a case of an unresponsive 32-year-old man who was found outside a steel manufacturing factory, taken to the emergency department by the police, and then declared dead. There were no external injuries apparent at autopsy; however, internal examination revealed a basilar skull fracture, subarachnoid hemorrhage, and multiple cystic lesions in the brain. NCC was confirmed by histopathological examination, which revealed cysticerci at different stages of development with accompanying inflammation and gliosis. The person may have been predisposed to seizures as a result of these histological abnormalities. The existence of underlying neuropathological disorders, such as neurocysticercosis (NCC), is an important finding in the context of unexplained sudden death, even when the precise mechanism of trauma could not be conclusively proven due to the lack of eyewitnesses and limited available investigation details. This case underscores the forensic relevance of NCC in unexplained deaths, especially among migrants from the endemic areas. A comprehensive postmortem examination, including past clinical history, background of migration, crime scene investigation, and histopathological analysis, is needed in such cases to help evaluate all possible contributions to the cause of death.