Forensic Science, Medicine and Pathology最新文献

{"title":"Neuropathological diagnoses and age-related differences in Finnish medico-legal autopsies of individuals aged 65 years and older.","authors":"Emma Pellikka, Paula K Vauhkonen, Petteri Oura","doi":"10.1007/s12024-026-01358-8","DOIUrl":"https://doi.org/10.1007/s12024-026-01358-8","url":null,"abstract":"<p><p>As populations worldwide continue to grow older, an increase in cases involving aged individuals is also to be expected in medico-legal autopsies. The aim of this study was to report the neuropathological diagnoses of individuals aged ≥ 65 years, and to compare the findings across three age groups: youngest-olds (65-74 years of age), middle-olds (75-84) and oldest-olds (≥ 85). The sample comprised all Finnish medico-legal autopsies of individuals aged ≥ 65 years whose autopsy included a full neuropathological examination performed by a neuropathologist over the period 2016-2022 (n = 629). Neuropathological diagnoses were obtained from the neuropathologists' reports, and background characteristics were collected from medico-legal cause-of-death investigation documents. Of all cases, 97.1% received at least one neuropathological diagnosis. The prevalences of many neurodegenerative diseases increased with age; Alzheimer's disease neuropathological change (30.5%) and cerebral amyloid angiopathy (14.0%) were the most common ones. However, some rarer neurodegenerative diseases were more frequent among youngest-olds. While the prevalence of acute infarcts remained relatively consistent across the age groups (12.4-14.5%), old infarcts and subarachnoid haemorrhages were most common among oldest-olds (22.1% and 16.6%, respectively). The age-related increase in subarachnoid haemorrhage diagnoses appeared to be primarily driven by the male sex. The prevalences of acute and old traumatic brain injuries were rather low (5.7-6.2% and 5.1%, respectively) and remained relatively stable across the age groups. In conclusion, our data suggest that neuropathological diagnoses are highly prevalent among aged individuals undergoing medico-legal autopsy, and many diagnoses become more frequent towards oldest-olds.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Material response under localised loading: proposed alternatives to ballistic gelatine for wound ballistics research.","authors":"James Read, Rachael Hazael, Richard Critchley","doi":"10.1007/s12024-026-01348-w","DOIUrl":"https://doi.org/10.1007/s12024-026-01348-w","url":null,"abstract":"<p><p>In experimentation where replication of the human torso is required, ballistic gelatine has historically been the baseline material for the international research community. However, with many test standards requiring the provision of ballistic gelatine from a limited number of suppliers, and shrinking research budgets becoming ever more prevalent, it is paramount that alternative materials are investigated with the aim of reducing economic impact and environmental concerns associated with the supply chain alongside becoming more ethically advantageous. Whilst previous works established a relationship between quasistatic mechanical response and penetration performance, this study advances that understanding by examining how loading rate and surface finish interactions modify this response under localised loading. This study presents the literature with a more complete interpretation of material behaviour that more closely resemble impact loading conditions and clarifies the limitations on relying solely on low strain-rate mechanical characterisation when assessing surrogate fidelity. It is proposed that both animal and plant-based alternatives reported herein may be used as viable alternatives to Ballistic Gelatine, with the authors recommending areas of further work to ensure the research community fully understand each material's limitations.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oronasal blood, intrathoracic petechiae and pulmonary hemorrhages differentiate prone separate-bed from bed-sharing SIDS cases.","authors":"Silje Osberg, Siri Hauge Opdal, Arne Stray-Pedersen","doi":"10.1007/s12024-026-01352-0","DOIUrl":"https://doi.org/10.1007/s12024-026-01352-0","url":null,"abstract":"<p><strong>Purpose: </strong>To compare autopsy findings in sudden infant death syndrome (SIDS) cases found prone in a separate bed with those occurring during bed-sharing, and to contrast these with confirmed asphyxia and violent death controls.</p><p><strong>Methods: </strong>We conducted a retrospective review of 313 SIDS cases from Southeast Norway (1984-2021) to assess forensic autopsy findings and death scene circumstances. A subset of cases was selected for blinded re-evaluation, with standardized microscopic examination of lung sections and semi-quantitative scoring of intra-alveolar hemorrhage.</p><p><strong>Results: </strong>As SIDS incidence declined, the proportion of bed-sharing cases increased from 7% in the 1980s to 52% after 2010 (p < 0.001). Bed-sharing SIDS infants were younger, more often found supine, and more frequently had oronasal blood and intra-alveolar hemorrhage reported. Separate-bed SIDS infants were predominantly found prone and more often exhibited petechiae on the surfaces of the thymus, lungs and heart. In the re-evaluated cohort, mean intra-alveolar hemorrhage scores were highest in bed-sharing SIDS (3.0 on a 0-4 scale) compared with prone SIDS (1.1), strangulation (1.2), and violent deaths (1.6) (all p ≤ 0.01). Scores did not differ significantly between bed-sharing SIDS and suffocation (2.3). Intra-alveolar hemorrhage was not linked to cardiopulmonary resuscitation.</p><p><strong>Conclusion: </strong>Pulmonary and intrathoracic findings in SIDS vary with sleep environment. Bed-sharing SIDS is associated with more severe intra-alveolar hemorrhage, whereas prone separate-bed SIDS more often shows intrathoracic petechiae. These findings suggest that bed-sharing-related and prone-related SIDS represent distinct pathological patterns with different underlying causes and death mechanisms, although both conditions remain unexplained.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of intracerebral hemorrhage in putrefied pig brains using computed tomography, magnetic resonance imaging and a urine test strip.","authors":"Markus Enders, Dominic Gascho, Fabian Morsbach, Michael J Thali, Stephan A Bolliger","doi":"10.1007/s12024-026-01350-2","DOIUrl":"https://doi.org/10.1007/s12024-026-01350-2","url":null,"abstract":"<p><p>The autoptic detection of intracerebral hemorrhages in putrefied brains is challenging, Imaging techniques such as post-mortem computed tomography and magnetic resonance imaging have proven to be useful in the detection of such findings in decomposed brain tissue.Urine test strips have long been used to detect various substances, including blood, in the urine. To evaluate their suitability for detecting blood in decomposed brain tissue, 1.5 mL of human blood was instilled into three pig brains, while three control brains received 1.5 mL tap water. The brains were let to decompose at 25 °C for 15 days, during which computed tomography and magnetic resonance scans were performed at regular intervals in order to detect hemorrhage-suspicious areas.After 15 days, the brains were extracted and 100 µL of brain tissue were mixed in 500 mL tap water. The urine test strip Medi-Test Uryxxon® turned slightly positive for hemoglobin in the control group and highly positive in the test group.In contrast, imaging techniques failed to detect the intracerebral hemorrhages, likely due to the small hemorrhage volume and, in the case of magnetic resonance imaging, lack of tissue reaction. With progressing putrefaction, the anatomy of the brains ceased to be appreciable.These findings suggest that a urine test strip such as the Medi-Test Uryxxon® may provide a simple qualitative method for detecting small intracerebral hemorrhages in putrefied brains where imaging techniques fail.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal difficulties in a death due to delayed traumatic rupture of massive sarcoid spleen with rivaroxaban therapy.","authors":"Aarathi Devi, Ruchir Arora, Frederick Johnson, Christopher Paul Johnson","doi":"10.1007/s12024-026-01349-9","DOIUrl":"https://doi.org/10.1007/s12024-026-01349-9","url":null,"abstract":"<p><p>Splenic rupture is a potentially fatal event, most frequently associated with blunt abdominal trauma. We hereby present an unusual post-mortem case of delayed splenic rupture occurring 5.5 days after a single punch to the chest. The case was further complicated by massive sarcoid splenomegaly and rivaroxaban therapy prescribed for prior deep vein thrombosis. Detailed histopathological examination of an overlying rib fracture and an organizing splenic hematoma revealed healing changes entirely consistent with the reported injury timeframe. The combined effects of trauma, underlying granulomatous disease, and anticoagulation contributed to progressive subcapsular splenic hemorrhage, ultimately resulting in delayed capsular rupture and fatal hemoperitoneum. Integration of histological evidence with the documented timeline of the assault enabled the Crown Prosecution Service to pursue a manslaughter charge against the alleged assailant. This case highlights the challenges of establishing causality when a significant interval separates trauma from death.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microscopic vessel caliber patterns in pulmonary thromboembolism: Clinical and autopsy correlations in a 10-year autopsy series.","authors":"Bekir Dinçer, Emre Nuri İğde, Fatma Tuğba Erkman, Doğuş Özdemir Kara, Hümeyra Yilmaz, Ahmet Depreli","doi":"10.1007/s12024-026-01347-x","DOIUrl":"https://doi.org/10.1007/s12024-026-01347-x","url":null,"abstract":"<p><p>To evaluate the relationship between microscopic pulmonary thromboembolism (PTE) patterns and clinical and autopsy variables in a large autopsy series. A retrospective review of 18,585 autopsies performed between 2014 and 2023 was conducted, from which 304 cases with PTE were included. Macroscopic and histopathological findings were compared, and microscopic involvement was categorized into large-, medium-, and small-caliber arterial patterns. Associations between clinical characteristics, circumstances of death, and autopsy variables were analyzed using chi-square test and multinomial logistic regression. Macroscopic examination was highly sensitive for the detection of large-vessel PTE (91.9%) but had markedly lower sensitivity for medium- and small-caliber arterial involvement (14.3% and 3.8%, respectively). Microscopic arterial patterns were significantly associated with history of surgery, infection, cerebrovascular events, place of death, autopsy period, and deep vein thrombosis (DVT) evaluation (p < 0.05). No significant associations were observed with sex, age, or major chronic diseases. The absence of macroscopic DVT evaluation and in-hospital death were independently associated with medium- and small-caliber arterial patterns in multinomial regression analysis. Microscopic vascular distribution of PTE is associated with clinical and autopsy-related factors. Macroscopic examination alone may underestimate the involvement of medium- and small-caliber pulmonary arteries. Systematic histopathological evaluation is essential for accurate diagnosis and characterization of PTE.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden cardiac death revealing extensive cardiovascular IgG4-related disease: a forensic autopsy case report.","authors":"Rihem Kouada, Oumaima Meddeb, Imen El Aini, Chahnez Makni, Zaineb Nfikha, Badreddine Sriha, Mohamed Ben Dhiab","doi":"10.1007/s12024-026-01346-y","DOIUrl":"https://doi.org/10.1007/s12024-026-01346-y","url":null,"abstract":"<p><p>Cardiovascular IgG4-related disease (IgG4-RD) is a rare and potentially lethal condition that may remain entirely clinically silent until sudden death occurs. We report a forensic autopsy case of extensive cardiovascular IgG4-RD involving the ascending aorta, pericardium, coronary arteries and the intrinsic cardiac nerve plexuses a finding, that, to the best of our knowledge, has not been previously reported in cardiovascular IgG4-RD. A complete forensic autopsy was performed, including comprehensive gross examination of the heart and great vessels. Histopathological evaluation and immunohistochemical staining (IgG4 and IgG) were undertaken. The diagnosis was established according to the 2019 American College of Rheumatology/European League Against Rheumatism classification criteria. The autopsy demonstrated diffuse fibroinflammatory involvement of multiple cardiovascular structures, including the ascending aorta, the pericardium, coronary arteries, myocardium, and intrinsic cardiac nerve plexuses. Histological examination revealed dense lymphoplasmacytic infiltrates with storiform fibrosis and abundant IgG4-positive plasma cells at all affected sites, with a maximum count of 32 IgG4- positive cells plasma cells per high power field (HPF) and an IgG4/IgG ratio exceeding 40%. The cumulative ACR/EULAR score reached 31 points, confirming IgG4-RD. The coexistence of extensive myocardial fibrosis and inflammatory infiltration surrounding the intrinsic cardiac autonomic nerve plexuses raises the possibility of a previously unrecognized arrhythmogenic mechanism that may have contributed to the fatal event. This case expands the clinicopathological spectrum of cardiovascular IgG4-RD by documenting previously unreported involvement of the intrinsic cardiac nerve plexus. It underscores that IgG4-RD remains clinically silent despite extensive cardiovascular damage and may present solely as sudden cardiac death. A meticulous forensic autopsy, complemented by targeted histopathological and immunohistochemical investigations, is essential for establishing the diagnosis.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body refrigeration on decomposition and postmortem interval estimation.","authors":"Victor Chungwane, Lawrence Hill, Craig A Keyes","doi":"10.1007/s12024-026-01355-x","DOIUrl":"https://doi.org/10.1007/s12024-026-01355-x","url":null,"abstract":"<p><strong>Purpose: </strong>Estimating the postmortem interval (PMI) is a critical component of forensic investigations. Refrigeration is routinely used to slow or halt decomposition prior to autopsy; however, its impact on PMI estimation using total body score (TBS) and entomological methods remains insufficiently understood.</p><p><strong>Methods: </strong>This study used ten domestic pig (Sus scrofa domesticus) carcasses (20-40 kg) decomposed under controlled conditions. Two controls were included: one remained unrefrigerated for 17 days and one refrigerated for 17 days. Eight experimental carcasses decomposed subaerially for 4, 7, 10, or 13 days before being refrigerated for four days, simulating standard forensic practice. Daily TBS, body and ambient temperatures, and accumulated degree days were recorded. PMI estimates were calculated at the end of both the subaerial and refrigeration periods using TBS and entomological approaches.</p><p><strong>Results: </strong>PMI estimates were most accurate when calculated prior to refrigeration, with 100% accuracy for both TBS (using body temperature) and entomological methods (using ambient temperature). Accuracy decreased following refrigeration to 75% for both methods. In inaccurate cases, refrigeration consistently led to PMI overestimation.</p><p><strong>Conclusion: </strong>These findings indicate that refrigeration negatively affects the accuracy of PMI estimation using both TBS and entomological methods. Consequently, PMI should be estimated prior to refrigeration wherever possible to improve forensic accuracy.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal air embolism associated with HELLP syndrome following first-trimester pregnancy termination: An autopsy-based case report.","authors":"Aykut Yildirim, Ismail Coban","doi":"10.1007/s12024-026-01351-1","DOIUrl":"https://doi.org/10.1007/s12024-026-01351-1","url":null,"abstract":"<p><p>In forensic practice, sudden maternal deaths following obstetric procedures require meticulous postmortem investigation to establish the cause of death. Although pregnancy termination is generally considered a safe procedure, rare but potentially fatal complications may occur. Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome and venous air embolism are individually uncommon but life-threatening conditions. A 23-year-old woman (gravida 2, para 1) at 9 weeks and 6 days of gestation underwent an uncomplicated elective pregnancy termination following normal preoperative laboratory findings. Within a few hours after the procedure, she developed gastrointestinal symptoms, hypotension, rapidly progressive thrombocytopenia, elevated liver enzyme levels, and laboratory evidence of hemolysis. Despite intensive resuscitative efforts, she died. A meticulous medico-legal autopsy employing the underwater pericardial water-filling technique demonstrated abundant intracardiac air within the right ventricle, while the overall clinical and laboratory findings supported the diagnosis of HELLP syndrome. This case highlights the fatal coexistence of early-onset HELLP syndrome and venous air embolism following first-trimester pregnancy termination. It underscores the importance of comprehensive clinicopathological correlation and meticulous forensic autopsy in accurately determining the cause of unexplained maternal death.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: Post-mortem supravital skeletal muscle excitability for early post-mortem interval estimation: a scoping review and methodological map.","authors":"Burkhard Madea, Elke Doberentz","doi":"10.1007/s12024-026-01345-z","DOIUrl":"https://doi.org/10.1007/s12024-026-01345-z","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}