{"title":"Tension hydrothorax complicating syringopleural shunt for post-traumatic syringomyelia.","authors":"Michael Duffy, Yeliena Baber, Chris O'Donnell","doi":"10.1007/s12024-024-00827-2","DOIUrl":"10.1007/s12024-024-00827-2","url":null,"abstract":"<p><p>Syringomyelia is a rare phenomenon that is typically associated with Chiari malformations. However, they can occur in the setting of post-traumatic spinal injury. Potential diversion treatments include syringopleural (SPS), syringoperitoneal and syringosubarachnoid shunts. Short-term complications have been reported in the literature, however, long term complications are not well documented. This case report is of a 43-year-old woman found deceased in bed. She had a history of a traumatic spinal injury following a motor vehicle accident 15 years prior to death. This was complicated by a syringomyelia/syrinx requiring a SPS insertion. Post-mortem imaging and autopsy findings demonstrated a large right tension hydrothorax with dense fibrosis of the pleural surfaces, contralateral diffuse alveolar damage lung changes histologically and a patent SPS. Her cause of death was registered as \"Right tension hydrothorax and diffuse alveolar damage complicating right syringopleural shunt and thoracic syrinx\".</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"267-272"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765910","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}
Zehua Fan, Ji Zhang, Chunling Ma, Bin Cong, Ping Huang
{"title":"The application of vibrational spectroscopy in forensic analysis of biological evidence.","authors":"Zehua Fan, Ji Zhang, Chunling Ma, Bin Cong, Ping Huang","doi":"10.1007/s12024-024-00866-9","DOIUrl":"10.1007/s12024-024-00866-9","url":null,"abstract":"<p><p>Vibrational spectroscopy is a powerful analytical domain, within which Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy stand as exemplars, offering high chemical specificity and sensitivity. These methodologies have been instrumental in the characterization of chemical compounds for an extensive period. They are particularly adept at the identification and analysis of minute sample quantities. Both FTIR and Raman spectroscopy are proficient in elucidating small liquid samples and detecting nuanced molecular alterations. The application of chemometrics further augments their analytical prowess. Currently, these techniques are in the research phase within forensic medicine and have yet to be broadly implemented in examination and identification processes. Nonetheless, studies have indicated that a combined classification model utilizing FTIR and Raman spectroscopy yields exceptional results for the identification of biological fluid-related information and the determination of causes of death. The objective of this review is to delineate the current research trajectory and potential applications of these two vibrational spectroscopic techniques in the detection of body fluids and the ascertainment of causes of death within the context of forensic medicine.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"406-416"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046559","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":"Hereditary thrombophilia as a possible risk factor for severe disease in COVID-19: a case series.","authors":"Jonathan Tse, Julita Gongolli, Joseph A Prahlow","doi":"10.1007/s12024-024-00879-4","DOIUrl":"10.1007/s12024-024-00879-4","url":null,"abstract":"<p><strong>Purpose: </strong>The risk factors that modulate one's susceptibility for severe COVID-19 have been well documented. Despite this, hypercoagulability remains an often overlooked risk factor for severe disease for COVID-19. Because COVID-19 infection is a risk factor for hypercoagulability, a reasonable presumption/hypothesis is that patients with hereditary thrombophilia would be at a higher risk of thrombotic complications associated with COVID-19 infection.</p><p><strong>Methods: </strong>This case report details two cases where previously unknown hereditary thrombophilias likely contributed to the mortality of COVID-19 patients.</p><p><strong>Results: </strong>The first COVID-19 patient's cause of death was pulmonary thromboemboli from deep vein thrombosis due to heterozygous MTHFR C667T and heterozygous PAI-1 4G/5G mutations. The second COVID-19 patient's cause of death was an acute myocardial infarct due to a coronary artery thrombosis in the setting of heterozygous MTHFR A1298C and homozygous PAI-1 4G/5G mutations. In each case, COVID-19 infection was also considered contributory to death.</p><p><strong>Conclusion: </strong>The occurrence of these fatal thrombotic events in COVID-19 patients with hereditary thrombophilias raises questions as to whether this combination of thrombotic risk factors for hypercoagulability may have placed patients at a significant enough risk to experience these fatal thrombotic complications. Thus, while not sufficient alone to prove that SARS-CoV-2 patients with hereditary thrombophilias are at increased risk for thrombotic complications, these two cases indicate that further investigation is warranted into elucidating the relationship between thrombotic risk factors as it may identify an additional high-risk medical condition for COVID-19 and have important diagnostic and therapeutic ramifications.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"260-266"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344648","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":"Death in a bathtub of an adolescent with neurofibromatosis type 2 exhibiting meningioangiomatosis with white matter involvement.","authors":"Kentaro Sakai, Kino Hayashi","doi":"10.1007/s12024-024-00867-8","DOIUrl":"10.1007/s12024-024-00867-8","url":null,"abstract":"<p><p>Neurofibromatosis type 2 (NF2) is a neurocutaneous syndrome characterized by the development of multiple benign tumors, including vestibular schwannomas and meningiomas, in the nervous system. Seizures are rarely associated with NF2, and the lethality of this condition typically stems from tumor growth and related complications, leaving the incidence of sudden death largely unreported. This report discribes a 16-year-old girl with a history of NF2 and occasional seizures who died unexpectedly in a bathtub. Postmortem examination revealed multiple tumors in the cranial nerves (schwannoma), under the dura mater (meningioma), and in the upper cervical cord (neurofibroma). Typical signs of drowning, such as foam in the airways, were not present. Upon histological examination, meningioangiomatosis (MA) was observed in the cerebellum and the cerebral cortex, specifically in the frontal lobe, temporal lobe, and insula. The MA extended into the white matter, exhibiting severe perivascular fibrosis and cystic dilatation of perivascular spaces in the frontal lobe and cerebellum. Additionally, glial microhamartomas were detected both around and separate from the MA. These autopsy findings suggest that sudden unexpected death in epilepsy (SUDEP) was the cause of death rather than drowning. Moreover, while NF2-associated MA is typically asymptomatic, unlike sporadic MA, which commonly presents with seizures, the spread of MA into the white matter is unusual in an NF2 patient. Therefore, MA with the white matter involvement could have been a factor causing the seizures and the occurrence of SUDEP in this NF2 patient.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"283-289"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046556","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":"Death following cylindrical battery ingestion associated with toxic manganese levels.","authors":"Eulalie Pefferkorn, Bruno Clément, Agathe Bascou, Céline Guilbeau-Frugier, Norbert Telmon, Frédéric Savall, Fabrice Dedouit","doi":"10.1007/s12024-024-00854-z","DOIUrl":"10.1007/s12024-024-00854-z","url":null,"abstract":"<p><p>Cases of battery ingestion are well documented in the scientific literature, especially concerning button cell battery ingestion in children. In this instance, the authors present an atypical case of a young man who voluntarily ingested a cylindrical alkaline battery containing manganese. The patient died approximately a week later, despite not exhibiting any specific symptoms. The battery was found in the cecum during the autopsy, showing deterioration at its positive pole. The cecal mucosa exhibited two ulcerations without perforation. Histological analysis revealed intestinal ischemia in the cecum, with no microscopic lesions in other organs. Toxicology reports indicated high levels of manganese in both cardiac and peripheral blood. Considering all the results from the additional analyses, the experts concluded that the death was likely of multifactorial origin, associated with a toxic blood concentration of manganese. To the best of our knowledge, this is the first recorded death following the ingestion of a cylindrical battery, and the first instance of manganese intoxication resulting from the ingestion of an alkaline battery. The authors will present the case and provide a literature review to assess the extent to which the presence of manganese may have contributed to the fatality.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"295-301"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476333","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}
Nicole Pasin, Matteo Lorenzoni, Erika Velotta, Giulio Riva, Raffaella Scotto Opipari, Mara Di Pietro, Roberta Tamiozzo, Umberto Nardi
{"title":"Invasive aspergillosis leading to fatal cerebral hemorrhage: a case report and comprehensive literature review.","authors":"Nicole Pasin, Matteo Lorenzoni, Erika Velotta, Giulio Riva, Raffaella Scotto Opipari, Mara Di Pietro, Roberta Tamiozzo, Umberto Nardi","doi":"10.1007/s12024-025-00966-0","DOIUrl":"https://doi.org/10.1007/s12024-025-00966-0","url":null,"abstract":"<p><p>Aspergillus fumigatus significantly threatens immunocompromised individuals by causing potentially fatal diseases, primarily invasive aspergillosis (IA). IA, mostly affecting the lungs, can disseminate to other organs, including the central nervous system (CNS), leading to high mortality rates. We present the case of an 84-year-old immunocompetent male with a history of significant comorbidities, who developed a lethal subarachnoid and tetraventricular hemorrhage. Initial symptoms included paroxysmal neuralgic pain and ophthalmic manifestations. Despite diagnostic efforts, the infection was confirmed only after a positive Aspergillus galactomannan antigen test on cerebrospinal fluid, post-mortem microbiological culture, and mass spectrometry (MS) authentication. The patient exhibited rapid deterioration and succumbed due to the erosion of a mycotic cerebral aneurysm of the left internal carotid artery. Diagnosing IA, particularly isolated CNS IA in immunocompetent patients, is challenging due to its nonspecific symptoms and difficulty detecting the pathogen in standard diagnostic tests. This article emphasizes the pivotal role of pathological examination to obtain a definitive diagnosis, assess fungal infiltration of brain vessels, and thus clarify the accurate source of fatal brain hemorrhages.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491507","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}
S Schof, J Hertzberg, A Jahnke, Christoph G Birngruber
{"title":"Exsanguination from an arteriovenous dialysis fistula: accident, suicide or medical malpractice?","authors":"S Schof, J Hertzberg, A Jahnke, Christoph G Birngruber","doi":"10.1007/s12024-025-00955-3","DOIUrl":"https://doi.org/10.1007/s12024-025-00955-3","url":null,"abstract":"<p><p>A female senior dialysis patient was found dead in her apartment, covered in blood. Bloodstains were observed in different rooms of the apartment. During the post-mortem examination on site, a small, roundish opening of the skin was observed on the flexor side of the upper arm, within a longitudinal scar, from which blood was draining. Throughout police investigation, the possibility of an accident, a suicidal act, or medical malpractice during dialysis care was considered. An autopsy was ordered for further clarification. The autopsy identified exsanguination from a fistula on the flexor side of the left upper arm as the cause of death. The fistula could be traced into an arteriovenous shunt vessel that had been created a long time ago for dialysis. Upon projection onto the shunt vessel, punctiform crusts with underlying hemorrhages in the subcutaneous fatty tissue were identified in the skin. Histological examinations of the fistula and its surrounding tissue revealed no evidence of vasculitis or perivascular inflammatory changes, but puncture sites of varying ages with connective tissue texture disruption of the vessel wall and the adjacent subcutaneous tissue. Forensic medical examination concluded that death was caused by bleeding from an arteriovenous dialysis shunt vessel as a complication of hemodialysis. This case illustrates the relevance of comprehensive forensic medical case processing as the basis for a well-founded assessment.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482636","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}
Annachiara Vinci, Laura Laura Ambrosi, Marcello Benevento, Davide Ferorelli, Biagio Solarino
{"title":"A singular case of complex suicide by hanging with hesitation marks by axe.","authors":"Annachiara Vinci, Laura Laura Ambrosi, Marcello Benevento, Davide Ferorelli, Biagio Solarino","doi":"10.1007/s12024-025-00964-2","DOIUrl":"https://doi.org/10.1007/s12024-025-00964-2","url":null,"abstract":"<p><p>We present a case of complex suicide concerning a 55-year-old man who hanged himself using a rope anchored to a beam on the terrace of his apartment. Multiple parallel linear wounds were observed on his head. At the crime scene, an axe stained with blood and hair was found resting against the wall adjacent to the stairs leading to the upper floor. Forensic investigations identify the cause of death as mechanical asphyxia due to the hanging, in a complex suicide characterized by hesitation marks inflicted on the head with an axe. This specific type of complex suicide has never been described in the literature.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467585","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}
Nevin Cavlak, Gökalp Çınarer, Mustafa Fatih Erkoç, Kazım Kılıç
{"title":"Sex estimation with convolutional neural networks using the patella magnetic resonance image slices.","authors":"Nevin Cavlak, Gökalp Çınarer, Mustafa Fatih Erkoç, Kazım Kılıç","doi":"10.1007/s12024-025-00943-7","DOIUrl":"https://doi.org/10.1007/s12024-025-00943-7","url":null,"abstract":"<p><p>Conducting sex estimation based on bones through morphometric methods increases the need for automatic image analyses, as doing so requires experienced staff and is a time-consuming process. In this study, sex estimation was performed with the EfficientNetB3, MobileNetV2, Visual Geometry Group 16 (VGG16), ResNet50, and DenseNet121 architectures on patellar magnetic resonance images via a developed model. Within the scope of the study, 6710 magnetic resonance sagittal patella image slices of 696 patients (293 males and 403 females) were obtained. The performance of artificial intelligence algorithms was examined through deep learning architectures and the developed classification model. Considering the performance evaluation criteria, the best accuracy result of 88.88% was obtained with the ResNet50 model. In addition, the proposed model was among the best-performing models with an accuracy of 85.70%. When all these results were examined, it was concluded that positive sex estimation results could be obtained from patella magnetic resonance image (MRI) slices without the use of the morphometric method.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448614","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":"Estimating the postmortem interval: applications of forensic acarology, palynology, and taphonomy.","authors":"John Oladapo Obafunwa, Amanda Roe, Leon Higley","doi":"10.1007/s12024-025-00954-4","DOIUrl":"https://doi.org/10.1007/s12024-025-00954-4","url":null,"abstract":"<p><p>Determination of the minimum postmortem interval remains an important factor in the investigation of deaths, especially homicides. It is important for near-accurate reconstruction of the fatal event, especially after putrefaction has commenced. It helps to weigh the alibi of suspects, and to include or exclude these individuals. The science of forensic entomology, acarology, palynology and taphonomy have been applied with varying degree of accuracy depending on a plethora of biotic and abiotic factors. Each of these specialties is most useful at specific times during decomposition and depending on local environmental factors. As decomposition progresses, the estimation of the PMI becomes more difficult. Here, we review how different forensic techniques are most appropriate for estimating the postmortem interval at different times since death. Ultimately, the determination of the interval is a difficult task requiring a multidisciplinary approach comprising many forensic specialists.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448610","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}