Legal Medicine最新文献

{"title":"Complete laryngotracheal separation following blunt neck trauma: A forensic reconstruction of an unusual fatal injury","authors":"Sarra Ben Abderrahim,&nbsp;Wael Majdoub,&nbsp;Souheil Mlayah,&nbsp;Raja Ghzel,&nbsp;Elyes Turki","doi":"10.1016/j.legalmed.2026.103012","DOIUrl":"10.1016/j.legalmed.2026.103012","url":null,"abstract":"<div><h3>Introduction</h3><div>Complete laryngotracheal separation (CLTS) is an exceptionally rare and life-threatening consequence of blunt neck trauma. Because external cervical injuries may be minimal or nonspecific, diagnosis can be delayed in both clinical and forensic settings.</div></div><div><h3>Case presentation</h3><div>A 35-year-old man was found unconscious at the roadside and died two hours after hospital admission despite emergency management. Autopsy revealed extensive cervical subcutaneous emphysema, complete laryngotracheal separation, bilateral thyroid cartilage fractures, cricoid cartilage disruption, destruction of the first tracheal ring, fracture of the left greater horn of the hyoid bone, and complete rupture of the left sternocleidomastoid, sternohyoid, and sternothyroid muscles. In contrast, external neck injuries were limited to abrasions and ecchymotic markings. The marked discrepancy between the severity of internal injuries and the relatively subtle external findings initially raised suspicion of homicidal violence. Differential forensic reconstruction considered strangulation, hanging, and road traffic trauma. Subsequent police investigation identified blood matching the deceased on an open engine ventilation grille of a passing bus. Correlation of the autopsy findings with scene investigation supported an unusual mechanism in which the victim sustained a high-energy lateral impact to the neck from the open ventilation grille, producing complete laryngotracheal separation.</div></div><div><h3>Conclusion</h3><div>This case illustrates an unusual mechanism of fatal blunt neck trauma. It highlights that severe laryngotracheal injuries may present with deceptively minor external signs, leading to delayed diagnosis and challenging forensic interpretation. Careful integration of autopsy findings with police investigation was essential for reconstructing the fatal event and distinguishing this accidental death from alternative medico-legal scenarios.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103012"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117682","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":"Siliceous non-diatom microorganisms as complementary indicators in forensic investigations of drowning deaths","authors":"Merle Dorsch,&nbsp;Philippe Lunetta,&nbsp;Atko Heinsalu,&nbsp;Jan Weckström","doi":"10.1016/j.legalmed.2026.103002","DOIUrl":"10.1016/j.legalmed.2026.103002","url":null,"abstract":"<div><div>The diatom test remains one of the most widely applied laboratory methods in the post-mortem diagnosis of drowning. However, its value may be limited in environments with low diatom abundance or in atypical aquatic settings. We surveyed the forensic relevance of additional siliceous, non-diatom microorganisms (chrysophyte cysts and scales, freshwater sponge spicules, ebridians, and phytoliths) detectable using standard diatom preparation techniques based on our expertise in the fields of paleoecology and marine biology, as well as the experience gained from more than 1500 diatom analyses of suspected drowning cases. These silica-based remains survive conventional acid digestion and provide additional information that can complement diatom findings. Integration of these indicators into routine microscopic evaluation of diatoms supports a multi-proxy approach, improving environmental interpretation and reducing diagnostic uncertainty, especially in diatom-poor or atypical drowning environments.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103002"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal bacterial CNS infections: a systematic review and a forensic case report","authors":"Jessika Camatti,&nbsp;Maria Paola Bonasoni,&nbsp;Rossana Cecchi,&nbsp;Irene Venturelli,&nbsp;Mattia Manelli,&nbsp;Stefano Ricci,&nbsp;Mirko Capucci,&nbsp;Anna Laura Santunione","doi":"10.1016/j.legalmed.2026.103009","DOIUrl":"10.1016/j.legalmed.2026.103009","url":null,"abstract":"<div><div>Central nervous system (CNS) infections may cause sudden unexpected death when diagnosis is delayed or missed. We report a fatal case of <em>Streptococcus pyogenes</em> meningoencephalitis and systematically review postmortem investigations of fatal bacterial CNS infections. A 57-year-old woman was found dead at home after untreated otalgia, hearing loss, purulent otorrhea, low-grade fever, asthenia, and vomiting. Autopsy showed diffuse cerebral edema, subdural empyema involving the posterior fossa, and cerebellar tonsillar herniation. Histology demonstrated acute suppurative meningoencephalitis with vasculitic injury. <em>Streptococcus pyogenes</em> was isolated from purulent material collected from the empyema; toxicological analyses were negative. The systematic review followed PRISMA 2020. PubMed/MEDLINE and Scopus were searched from database inception to 22 August 2026. Sixty-two studies describing 68 fatal bacterial CNS infections were included. The included cases showed a broad spectrum of postmortem-confirmed bacterial infections, including meningitis, meningoencephalitis, ventriculitis, brain abscess, subdural empyema, rhombencephalitis, spinal meningeal involvement, and infectious vascular complications. Postmortem pathogen-directed testing included culture, histochemical stains, antigen detection, immunohistochemistry, PCR, sequencing, MALDI-TOF identification, or equivalent methods. Autopsy remains central to diagnosing fatal bacterial CNS infections. Integration of neuropathology with postmortem pathogen-directed testing improves pathogen identification, cause-of-death determination, reconstruction of the route and mechanism of death, and infectious disease surveillance.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103009"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmortem nasal swab screening for cocaine: Preliminary evidence for early toxicological orientation in forensic autopsy practice","authors":"Pietro Zuccarello,&nbsp;Giulia Carnazza,&nbsp;Francesco Sessa,&nbsp;Nunziata Barbera","doi":"10.1016/j.legalmed.2026.103011","DOIUrl":"10.1016/j.legalmed.2026.103011","url":null,"abstract":"<div><div>Early toxicological information may be useful during death scene investigation and early autopsy, when decisions regarding sampling, ancillary analyses and investigative priorities must be made before conventional laboratory results are available. This preliminary study evaluated the analytical feasibility of nasal swab testing for postmortem cocaine screening and early toxicological orientation.</div><div>Nasal swabs were collected during 104 autopsies, extracted in phosphate buffer and analyzed using a rapid immunochemical screening test for cocaine metabolites. Each extract was tested in triplicate. All nasal swab extracts, regardless of screening result, were subsequently analyzed by LC-MS/MS for cocaine, benzoylecgonine, norcocaine and cocaethylene. Femoral blood was analyzed by LC-MS/MS, whereas urine was analyzed by immunochemical screening, with presumptive-positive samples subsequently confirmed by LC-MS/MS for cocaine and its metabolites.</div><div>Urine screening was presumptive-positive in 25 cases, all of which were confirmed by LC-MS/MS. Nasal swab screening was presumptive-positive in 22 cases and negative in 82. LC-MS/MS confirmed cocaine and/or metabolites in all 22 presumptive-positive nasal swab extracts, whereas all 82 screening-negative extracts were negative by LC-MS/MS. Three urine-confirmed positive cases were negative in femoral blood and nasal swab extracts. Norcocaine was detected in all LC-MS/MS-positive nasal swab extracts, whereas cocaethylene was detected in six cases and in the corresponding femoral blood and urine samples.</div><div>The detection of benzoylecgonine, norcocaine and cocaethylene increased the analytical and interpretive value of nasal swab findings beyond parent cocaine alone. These results support prospective studies to determine whether rapid nasal swab screening can contribute to early postmortem toxicological orientation in forensic practice.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103011"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117434","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 arrhythmia associated with myocardial contusion caused by a horse kick: A forensic autopsy case","authors":"Hiroki Kondou,&nbsp;Takumi Minamiyama,&nbsp;Hiroshi Ikegaya","doi":"10.1016/j.legalmed.2026.103007","DOIUrl":"10.1016/j.legalmed.2026.103007","url":null,"abstract":"<div><h3>Background</h3><div>Horse-related injuries often involve high-energy blunt trauma that can be fatal. In cases of chest trauma associated with horse kicks, death is typically attributed to structural cardiac injuries such as cardiac rupture or tamponade. Fatal arrhythmia associated with myocardial contusion following a horse kick has rarely been reported in the forensic literature.</div></div><div><h3>Case presentation</h3><div>A 48-year-old man was kicked in the left lower chest by the right hind limb of a Thoroughbred horse while handling the animal. The patient collapsed immediately after the impact. Emergency medical personnel documented ventricular fibrillation and performed repeated defibrillation. Despite advanced resuscitative efforts, including open-chest cardiac massage, death was confirmed.</div></div><div><h3>Autopsy findings</h3><div>External examination revealed a patterned abrasion and subcutaneous hemorrhage in the left hypochondrial region. Internal examination revealed a fracture of the left sixth rib, epicardial hemorrhage, and myocardial contusion. Intramyocardial hemorrhage extended into the anterior, lateral, and posterior walls of the left ventricle. Cardiac rupture or hemopericardium was not observed. Histological examination confirmed intramyocardial hemorrhage. Surgical findings related to the resuscitative thoracotomy were also observed.</div></div><div><h3>Conclusion</h3><div>Based on the circumstances of the incident, prehospital documentation of ventricular fibrillation, and autopsy findings, the cause of death was determined to be fatal arrhythmia associated with blunt chest trauma from a horse kick. This case highlights the importance of considering arrhythmic death as a potential mechanism in horse-related chest trauma, even in the absence of catastrophic structural cardiac injury, and emphasizes its significance in forensic death investigations.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103007"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117692","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 hyperthermia and heatstroke in children and adults: a ten-year retrospective autopsy-based analysis","authors":"Abdulkadir Can,&nbsp;Hüseyin Çağrı Şahin,&nbsp;Muhammed Fatih Yaman,&nbsp;İbrahim Üzün","doi":"10.1016/j.legalmed.2026.103008","DOIUrl":"10.1016/j.legalmed.2026.103008","url":null,"abstract":"<div><div>Hyperthermia is a preventable cause of death that lacks a specific postmortem finding, and its diagnosis relies on scene and environmental information and on the exclusion of alternative causes. We characterized the demographic, environmental, and pathological features of hyperthermia deaths over a ten-year period at a national forensic reference board and compared pediatric and adult patterns descriptively. Twenty-two cases certified as hyperthermia or heatstroke between 2015 and 2024 were reviewed retrospectively; investigation files, scene and meteorological records, clinical documents, autopsy and histopathology reports, and toxicology results were evaluated together, and cases were grouped as pediatric (&lt;18 years) or adult (≥18 years). Twelve cases were children and 10 were adults; 15 (68.2%) were male. Eleven children (91.7%) died inside parked vehicles, whereas adult deaths mostly occurred outdoors, in occupational settings, and under exertion. The maximum ambient temperature on the event day was ≥35 °C in 16 cases (72.7%; cohort median 37.0 °C). Nineteen cases (86.4%) had no antemortem medical contact. Cerebral congestion and pulmonary edema were common but non-specific, and chronic cardiac pathology was found only in adults. In this series, scene and exposure patterns differed between pediatric and adult cases—vehicular entrapment in children and exertional or occupational heat exposure in adults. Because no postmortem finding is specific, the forensic diagnosis should rest on the joint evaluation of scene and meteorological data with autopsy, histopathological, and toxicological findings and on the exclusion of alternative causes, and prevention should be tailored to age and exposure context.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103008"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117500","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":"Genetic analysis of 22 pigmentation-associated SNPs in the Pashtun population of Khyber Pakhtunkhwa, Pakistan: Implications for forensic DNA phenotyping","authors":"Sumaia Saif,&nbsp;Muhammad Israr,&nbsp;Allah Rakha,&nbsp;Midhat Salman,&nbsp;Muhammad Ilyas,&nbsp;Manzoor Hussain,&nbsp;Atif Adnan,&nbsp;Hongbo Wang","doi":"10.1016/j.legalmed.2026.103005","DOIUrl":"10.1016/j.legalmed.2026.103005","url":null,"abstract":"<div><div>The prediction of externally visible characteristics (EVCs) from DNA, known as forensic DNA phenotyping (FDP), has emerged as a powerful tool in forensic investigations. The HIrisPlex system, comprising 24 SNPs for eye and hair color prediction, has been extensively validated in European populations but shows reduced accuracy in South Asian populations. This study genotyped 22 pigmentation-associated SNPs using the SNaPshot minisequencing platform in 146 unrelated Pashtun individuals from Khyber Pakhtunkhwa (KP), Pakistan, to evaluate their forensic utility and phenotypic association in this understudied population. Minor allele frequencies (MAFs) ranged from 0.010 (rs885479) to 0.394 (rs28777), with 13 of 22 SNPs (59.1%) being polymorphic. Nine SNPs (N29insA, rs11547464, rs1805008, rs1805005, rs1805006, rs1805007, rs1805009, Y152OCH, rs1110400) were monomorphic, consistent with the dark pigmentation characteristic of South Asian populations. Hardy-Weinberg equilibrium testing revealed four SNPs (rs885479, rs4959270, rs12203592, rs2378249) deviating from equilibrium at <em>p</em> &lt; 0.05. Polymorphism information content (PIC) values ranged from 0.020 to 0.364 (mean = 0.128). Linkage disequilibrium analysis of 78 SNP pairs revealed no strong LD (r² &gt; 0.8), confirming marker independence. Pairwise FST analysis among six major ethnic subgroups (Yousafzai, Afridi, Khalil, Khattak, Momand, Wazir) indicated low genetic differentiation (FST &lt; 0.05 for 13 of 15 comparisons). SNP-phenotype association analysis identified rs12913832 (HERC2) as significantly associated with eye color (chi2 = 44.24, <em>p</em> = 3.02 × 10^-7, Cramer's V = 0.389) and rs16891982 (SLC45A2) as significantly associated with hair color (chi2 = 23.77, <em>p</em> = 0.008, Cramer's V = 0.285). Multinomial logistic regression models with 5-fold stratified cross validation achieved 88.3% accuracy for binary eye color (dark vs. light) and 83.6% for binary hair color, while multiclass predictions were lower (37.7% for eye color, 62.3% for hair color). These findings establish baseline population data for forensic DNA phenotyping in the Pashtun population and highlight the need for population-specific prediction models in South Asian groups.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103005"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065744","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 gastrointestinal complications of pica: Medico-legal findings from two forensic autopsy investigations","authors":"M. Benyagoub,&nbsp;R.S. Benazzouz,&nbsp;N. Mesbah,&nbsp;A. Mizab,&nbsp;F. Alem,&nbsp;Z. Guennouni,&nbsp;S. Iddir,&nbsp;L. Dali Braham,&nbsp;R. Belhadj","doi":"10.1016/j.legalmed.2026.103003","DOIUrl":"10.1016/j.legalmed.2026.103003","url":null,"abstract":"<div><h3>Background</h3><div>Pica is a behavioral disorder characterized by persistent ingestion of non-nutritive substances. Although primarily described in psychiatric contexts, it may lead to severe gastrointestinal complications and death. In forensic practice, such cases raise important medico-legal issues when the cause of death is unclear.</div></div><div><h3>Objectives</h3><div>To describe fatal gastrointestinal complications of pica, identify morphological indicators of chronic ingestion at autopsy, and demonstrate how systematic forensic examination contributes to accurate cause-of-death determination.</div></div><div><h3>Methods</h3><div>Two fatal cases of pica-related gastrointestinal complications were investigated by forensic autopsy following judicial requisition (2023–2024). Full autopsies were performed with systematic gastrointestinal exploration. Toxicological analyses were conducted and findings interpreted with clinical and investigative data.</div></div><div><h3>Results</h3><div>The first case involved a 56-year-old man died from generalized purulent peritonitis due to gastric perforation caused by massive coin ingestion. Autopsy revealed gastric distension, pyloric perforation with fibrotic margins, and 113 metallic coins. The second case concerned a 46-year-old woman with severe intellectual disability died from terminal intestinal obstruction with megacolon following repeated ingestion of heterogeneous materials. Both cases showed morphological features consistent with chronic ingestion. Toxicological analyses were negative.</div></div><div><h3>Conclusion</h3><div>These cases illustrate fatal complications of pica and highlight the critical role of forensic autopsy in establishing cause and mechanism of death and excluding alternative medico-legal hypotheses.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"86 ","pages":"Article 103003"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117317","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":"Corrigendum to “Facial soft tissue thickness in Yangtze River delta Han population: Accurate assessment and comparative analysis utilizing cone-beam CT” [Legal Med. 44 (2020) 101693]","authors":"Chuwei Deng,&nbsp;Dongmiao Wang,&nbsp;Ji Chen,&nbsp;Kai Li,&nbsp;Ming Yang,&nbsp;Zhuoyue Chen,&nbsp;Zhengyang Zhu,&nbsp;Caiyong Yin,&nbsp;Peng Chen,&nbsp;Dan Cao,&nbsp;Bin Yan,&nbsp;Feng Chen","doi":"10.1016/j.legalmed.2026.102959","DOIUrl":"10.1016/j.legalmed.2026.102959","url":null,"abstract":"","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"85 ","pages":"Article 102959"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlanto-occipital dislocation with upper cervical spinal cord injury difficult to detect on postmortem computed tomography: a case report","authors":"Kento Miura,&nbsp;Go Inokuchi,&nbsp;Fumiko Chiba,&nbsp;Sayaka Nagasawa,&nbsp;Yumi Hoshioka,&nbsp;Maiko Yoshida,&nbsp;Shigeki Tsuneya,&nbsp;Hirotaro Iwase","doi":"10.1016/j.legalmed.2026.102892","DOIUrl":"10.1016/j.legalmed.2026.102892","url":null,"abstract":"<div><div>Atlanto-occipital dislocation (AOD) is a high-energy traumatic injury associated with poor prognosis. Here, we report a case of AOD that could not be detected on postmortem computed tomography (PMCT). A man in his 70s was driving on a public road when he collided with a guardrail and struck an oncoming vehicle. At the time of contact with the emergency team, he was already in cardiopulmonary arrest. PMCT revealed hemorrhage in the third and fourth ventricles and around the brainstem suggestive of the pseudo-CT myelogram sign, as well as marked cervical deformity and fusion suggestive of diffuse idiopathic skeletal hyperostosis (DISH); however, no definite cervical spine injury could be identified. At autopsy, no significant external injuries were found; however, hemorrhage within the posterior cervical musculature and subarachnoid hemorrhage over the cerebellum were present. Observation of the spinal canal demonstrated hemorrhage at the atlanto-occipital junction, and a corresponding hemorrhage was also noted on the transverse section of the cervical spinal cord. The cause of death was judged to be cervical spinal cord injury associated with AOD. In this case, the dislocation of the neck was presumed to have been caused by excessive flexion resulting from the impact from the vehicle collision, with DISH being a contributing factor. Even in the absence of external injuries or CT-detectable cervical spine abnormalities, when abnormal cervical motion is suspected in fatal cases—particularly when postmortem CT shows DISH or a pseudo-CT myelogram sign—AOD or related cervical spinal cord injury should be considered.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"84 ","pages":"Article 102892"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310286","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}