Neck Injuries

颈部损伤
  • 文章类型: Case Reports
    此案对一个独特的杀害妇女案件进行了详细的法医检查,随后是犯罪者的自杀。
    在一个星期天的下午,一名52岁的男子在家中杀死了他43岁的伴侣,身上有11处刺伤。几分钟后,他用绳子吊死在他们家花园的树上自杀。这个独特的案例很有趣,因为杀人和自杀的方法相结合,以及受害者和犯罪者之间的关系动态。肇事者刺伤杀人,然后上吊自杀。
    该案例为法医学增添了宝贵的知识,倡导提高对家庭暴力和基于性别的暴力的认识和预防措施。这份报告深入分析了一起杀人自杀事件,专注于一个独特的杀人自杀案例。它强调了全球杀害妇女的危机。此案是在基于性别的暴力的背景下,说明了这种行为是如何深深植根于社会规范中的。它突出了亲密伴侣暴力的模式,情感因素起着重要作用。法医分析揭示了凶杀案的过度杀伤性质,表明过度伤害超出了死亡所必需的范围,反映了肇事者的心理动荡。它强调必须查明家庭环境中潜在暴力的迹象,并实施心理健康支持干预措施和预防基于性别的暴力。
    UNASSIGNED: This case presents a detailed forensic examination of a unique femicide case followed by the perpetrator\'s suicide.
    UNASSIGNED: On a Sunday afternoon, a 52 year old man killed his 43 year old partner in their home with eleven stab wounds. A few minutes later, he committed suicide by suspending himself to a tree in their home garden by means of a rope. This unique case is interesting because of the combination of methods used for both homicide and suicide, as well as the relationship dynamics between the victim and perpetrator. The perpetrator committed homicide by stabbing and then hanged himself.
    UNASSIGNED: The case adds valuable knowledge to Forensic Medicine, advocating for increased awareness and preventive measures against domestic and gender-based violence. This report provides an in-depth analysis of a homicide-suicide incident, focusing on a unique case of homicide-suicide. It serves to highlight the global crisis of femicide. The case is situated within the context of gender- based violence, illustrating how such acts are deeply rooted in societal norms. It highlights patterns of intimate partner violence, where emotional factors play a significant role. Forensic analysis uncovered the overkill nature of the homicide, indicating excessive injuries beyond what was necessary for death, reflecting the psychological turmoil of the perpetrator. It emphasizes the importance of identifying signs of potential violence in domestic settings and implementing interventions for mental health support and the prevention of genderbased violence.
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  • 文章类型: Case Reports
    近年来,法医实践共同标准的改进受到了关注,以推广一种明确和更高质量的法医调查方法。尽管大多数死亡都归因于自杀,案件偶尔发生由于事故或凶杀。从调查的角度来看,绞死通常很简单,但是异常情况可能会引起犯罪的怀疑。这包括复杂的自杀,这是受害者用两种或多种不同的致命方法追求的罕见事件,可以分为有计划的或无计划的,取决于方法是同时应用还是顺序应用。检测到的多种伤害往往会导致误解,因此,多学科方法极为重要。
    一个44岁的男人,在请求执法后,而是在距离他自己的财产几公里的一个无人居住的花园中被发现,用铁丝悬挂在横梁上;铁丝在他的后脑勺上形成了一个绞索,他的手放在脖子上,并发现了刺伤。
    犯罪现场调查,亲戚的采访,尸检,组织学和毒理学检查,GAP导致确定死亡是自杀。这种全面的方法强调了在法医案件中进行细致调查和分析以得出准确结论的重要性。
    UNASSIGNED: In recent years, the improvement of common standards of forensic practice has received attention to promote an unambiguous and better-quality forensic investigation method. Although most hanging deaths are attributed to suicides, cases occasionally occur due to accidents or homicides. From an investigative point of view, hanging deaths are usually straightforward, but unusual circumstances may raise suspicions of crime. This includes complex suicides, which are rare events pursued by victims with two or more different fatal methods and can be classified as planned or unplanned, depends on whether the methods are applied simultaneously or sequentially. The multiplicity of injuries detected can often lead to misinterpretations, thus making a multidisciplinary approach extremely important.
    UNASSIGNED: A 44-year-old man, after requesting law enforcement, has been instead found inside a garden of an uninhabited property located a few kilometers away from his own property, suspended from a beam with wire; the wire created a noose at the back of his head, his hands were placed at his neck, and stab wounds were found.
    UNASSIGNED: The crime scene investigation, interview of relatives, autopsy, histological and toxicological examinations, and GAP led to the determination that the death was suicide. This comprehensive approach emphasizes the importance of meticulous investigation and analysis to reach accurate conclusions in forensic cases.
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  • 文章类型: Case Reports
    背景:枪伤所致的穿透性颈部创伤(PNT)是具有挑战性的疾病之一,具有明显的发病率和死亡率。
    目的:脊柱枪伤患者的治疗方法存在重大问题。手术适应症,手术方法,脑脊液泄漏的管理是这些患者的主要关注点。
    方法:2天前,一名11岁的男孩因脑脊液漏和左臂无力,在后颈区域左侧有一处枪伤被转诊到我们中心。
    结果:患者接受了手术,并取出颗粒。手术后他的左臂无力完全恢复,在1年的随访中没有出现新的症状。
    结论:及时手术可以显著改善症状较轻的PNT患者的预后,并防止神经系统缺陷恶化。
    BACKGROUND: Penetrating neck trauma (PNT) due to gunshot injuries is one of the challenging conditions with the potential for both significant morbidities and mortality.
    OBJECTIVE: There are significant concerns in the approach to patients with spinal gunshot injuries. Surgery indications, methods of surgery, and management of CSF leaks are the main concerns of these patients.
    METHODS: An 11-year-old boy was referred to our center with a single gunshot wound to the left side of the posterior cervical region 2 days ago with cerebrospinal fluid leakage and left arm weakness.
    RESULTS: The patient underwent surgery, and the pellet was removed. His left arm weakness fully recovered after the operation, and no new symptoms developed during the 1-year follow-up.
    CONCLUSIONS: Timely surgery could dramatically improve outcomes in PNT patients with mild symptoms and prevent worsening neurological defects.
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  • 文章类型: Journal Article
    已经进行了几项研究来识别凶杀和自杀锐器伤口相关死亡的主要特征,揭示了在自杀案件中,颈部的单个切割伤口是罕见的事件,通常会在致命伤附近出现几个犹豫的痕迹。我们报告了一例非典型的自我造成的割喉伤害,没有涉及一名79岁女性的暂定标记。使用的武器,一把菜刀,是在犯罪现场发现的.伤口边缘干净,没有发现其他切口。现场情况,即没有闯入的迹象,在床上发现的受害者,那把刀位于尸体附近,易接近部位的重要伤口,没有防御伤害,集体支持可能的自杀。还进行了文献综述,以比较该病例与其他6例报告的非典型自杀的法医数据,这些非典型自杀的特征是毫不迟疑地切开喉咙。鉴于报道的病例很少,文献中缺乏粗略描述和组织病理学数据,对此类病例的更多了解可能有助于法医病理学家在观察到单个颈部损伤时识别自杀事件.在这个框架中,通过一个独特的单一切割喉咙自杀毫不犹豫的痕迹附近的致命伤害可以观察到作为一个非典型的表现,还有犯罪现场调查,连同死者的额外背景资料,帮助识别死亡的方式。
    Several studies have been performed to recognize the main features in homicide and suicide sharp wound-related death, revealing that a single cutting wound to the neck is an infrequent event in suicide cases, and several hesitation marks near the fatal injury are usually present. We report a case of an atypical self-inflicted cutthroat injury without tentative marks involving a 79-year-old female. The weapon used, a kitchen knife, was found at the crime scene. The wound had clean margins, and no other incisions were found. Scene circumstances, namely the absence of signs of a break-in, the victim found on the bed, the knife located near the body, the vital wound in an accessible site, and the absence of defense injuries, collectively support a likely suicide. A literature review was also performed to compare forensic data of the case presented with the other 6 cases reported regarding atypical suicide characterized by a single incising cut to the throat without hesitation marks. Given the few cases reported and the lack of gross descriptions and histopathological data available in the literature, additional knowledge of such a case may help forensic pathologists in the identification of suicidal events when a single neck injury is observed. In this frame, suicide by a unique single incising cut to the throat without hesitation marks near the lethal injury may be observed as an atypical presentation, and the crime scene investigation, together with additional background information of the deceased, aid in the identification of the manner of the death.
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  • 文章类型: Case Reports
    背景:椎动脉损伤在创伤环境中是一种罕见的疾病。在高级阶段,它会导致死亡。
    方法:一名31岁的孙丹妇女患有脑水肿,C2-C3前旋,摩托车事故后的LeFortIII骨折被送往急诊室。第五天,她在全身麻醉中接受了上颌下颌弓弓的应用和清创术,颈部位置过度伸展。不幸的是,手术前,她的僵硬颈圈在高监护病房被移除。手术后72小时,她的病情恶化。数字减影血管造影显示,由于颈椎移位,双侧椎动脉损伤为5级,左颈内动脉损伤为4级,伴有颈动脉海绵窦瘘(CCF)。CCF盘绕后脑灌注未改善,患者被宣布脑死亡。
    结论:该患者脑血管损伤后脑灌注不足导致的脑死亡可以通过早期血管内介入和宫颈固定来预防。
    BACKGROUND: Vertebral artery injury is a rare condition in trauma settings. In the advanced stages, it causes death.
    METHODS: A 31-year-old Sundanese woman with cerebral edema, C2-C3 anterolisthesis, and Le Fort III fracture after a motorcycle accident was admitted to the emergency room. On the fifth day, she underwent arch bar maxillomandibular application and debridement in general anesthesia with a hyperextended neck position. Unfortunately, her rigid neck collar was removed in the high care unit before surgery. Her condition deteriorated 72 hours after surgery. Digital subtraction angiography revealed a grade 5 bilateral vertebral artery injury due to cervical spine displacement and a grade 4 left internal carotid artery injury with a carotid cavernous fistula (CCF). The patient was declared brain death as not improved cerebral perfusion after CCF coiling.
    CONCLUSIONS: Brain death due to cerebral hypoperfusion following cerebrovascular injury in this patient could be prevented by early endovascular intervention and cervical immobilisation.
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  • 文章类型: Journal Article
    在世界特定地区,枪支自杀是一个重大的公共卫生问题。根据枪支的可用性,可以使用任何类型的枪支,包括手枪,猎枪,和长步枪。自杀式枪伤的常见入口伤口包括头部,包括寺庙在内的经典枪伤地点,前额,下巴的下颌部分,在嘴里。偶尔,自杀性枪伤发生在非典型的身体部位,如头部和颈部的后部。鉴于它们的相对稀有性,这些地区的自杀性枪伤可能被误认为是凶杀。在这份报告中,我们报告了5例头部和/或颈部后部的自杀性枪伤。在我们的系列中,我们专注于区分每个案件与涉及头部和颈部类似区域枪伤的凶杀案。
    UNASSIGNED: Suicide by firearm is a significant public health concern in specific regions of the world. Depending on firearm availability, any type of firearm may be used, including handguns, shotguns, and long rifles. Common entrance wound sites in suicidal gunshot wounds include the head, with classic gunshot wound locations including the temple, the forehead, the submental aspect of the chin, and inside the mouth. Occasionally, suicidal gunshot wounds occur in atypical body locations such as the back of the head and neck. Given their relative rarity, suicidal gunshot wounds in these regions may be mistaken for homicides. In this report, we present 5 cases of suicidal gunshot wounds to the back of the head and/or neck. In our series, we focus on differentiating each case from homicides involving gunshot wounds in similar areas of the head and neck.
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  • 文章类型: Case Reports
    尸检时通常会遇到死后动物清除产生的文物。了解死后动物清除产生的伪影模式对于正确解释尸检结果至关重要。在家庭死亡中,这些文物通常是由家畜和苍蝇等小昆虫引起的,蚂蚁,甲虫,等。蚂蚁是以尸体为食的早期食腐动物之一。死后蚂蚁活动产生的伪影通常是浅表和非出血类型。很少,在充血的身体区域和明显的低姿势区域,由于蚂蚁叮咬而导致的死后出血伪影是可能的。在报告的绞刑案例中,这种死后出血的文物出现在两条腿上,主要是左腿。结扎区也存在浅表划伤形式的典型蚂蚁咬伤病变,在两个乳头周围和腹部下部。形态学上,蚂蚁叮咬产生的死后出血伪影表现出四种模式:液滴模式,条纹图案,泳池模式,和混合模式。在这种情况下,观察到死后出血伪影的混合模式(液滴模式和条纹模式)。下肢上存在死后出血伪影归因于由于身体悬浮而导致的血液积聚,然后是蚂蚁咬伤导致的被动血液逸出。当病变的起源不清楚时,应考虑蚂蚁叮咬产生此类伪影的可能性。
    Artifacts produced by postmortem animal scavenging are commonly encountered at autopsy. Knowledge of the pattern of artifacts produced by postmortem animal scavenging is essential for the correct interpretation of the autopsy finding. In household deaths, such artifacts are usually caused by domestic animals and by small insects such as flies, ants, beetles, etc. Ants are one of the early scavengers which feed on the dead bodies. The artifacts produced by the postmortem ant activity are usually superficial and non-bleeding type. Rarely, in the congested body regions and areas of marked hypostasis, postmortem bleeding artifacts due to ant bites are possible. In the reported case of hanging, such postmortem bleeding artifacts were present over both the legs, predominantly over the left leg. Typical ant bite lesions in the form of superficial excoriations were also present over the peri-ligature area, over and around both nipples and over the lower part of the abdomen. Morphologically, postmortem bleeding artifacts produced by ant bites exhibit four patterns: droplet pattern, stripe pattern, pool pattern, and mixed pattern. In this case, a mixed pattern (droplet pattern and stripe pattern) of postmortem bleeding artifacts was observed. The presence of postmortem bleeding artifacts over the lower limbs was attributed to the pooling of the blood due to suspension of the body, followed by passive escape of blood due to ant bites. The possibility of such artifacts produced by ant bites should be considered when the origin of the lesion is unclear.
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  • 文章类型: Review
    背景:骨内血管瘤是一种罕见的骨良性血管瘤,可影响身体任何部位;然而,最常见的部位是椎骨,其次是颅骨。
    方法:我们介绍了一例23岁男性骨内血管瘤的病例,该病例在3个月内出现咽部饱胀感。舌骨水平具有约5cm的硬块。细针抽吸显示5mL深色带血抽吸物。磁共振图像显示舌骨体中5.3cm混合信号强度病变。
    方法:组织病理学检查显示骨内血管瘤伴舌骨动脉瘤样骨囊肿(ABC)样改变。
    方法:团块被完全去除而没有显著问题。
    结果:获得了完整的肿块切除和症状改善,并且没有观察到随后的复发。
    结论:作者经历了一例伴有ABC样改变的骨内血管瘤。没有舌骨骨内血管瘤的病例报道。这种情况显示了从潜在的骨肿瘤发展为继发性变化的ABC样变化的光谱模式。骨肿瘤的ABC样变化可能会误导诊断。仔细检查肿瘤对于正确诊断ABC或ABC样变化至关重要。
    BACKGROUND: Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones.
    METHODS: We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body.
    METHODS: Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone.
    METHODS: The mass was completely removed without significant problems.
    RESULTS: Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed.
    CONCLUSIONS: The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.
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  • 文章类型: Case Reports
    虽然罕见,穿透性颈部损伤会有严重的后果,并与高死亡率有关。由于木制异物而导致宫颈损伤的个体发生感染性并发症的风险增加。在这种情况下,一名27岁的男性患者,颈部受伤,表明木制异物引起的穿透性伤口。计算机断层扫描(CT)扫描未显示颅内出血或骨折的迹象。此外,宫颈CT扫描未显示宫颈体部或颈长肌肉病变。医疗小组建议进行宫颈磁共振成像(MRI)检查;但是,病人的家人选择退出。随后,病人接受了伤口清创术,其中涉及提取一块刺穿木材的碎片。手术后两天,患者同侧出现发烧和肩膀和手臂无力。在再教育过程中,家属同意进行MRI检查.根据MRI发现和临床表现对患者进行后续外科手术。剩余的木质碎片被有效地提取,导致患者病情的积极进展。
    Although rare, penetrating neck injuries can have grave consequences, and are associated with high mortality rates. Individuals with cervical injuries due to wooden foreign bodies are at an increased risk of developing infectious complications. In this case, a male patient aged 27 years presented with a cervical injury indicative of a penetrating wound caused by a wooden foreign body. Computed tomography (CT) scan revealed no signs of intracranial hemorrhage or fracture. Additionally, cervical CT scan showed no evidence of cervical corpus or longus colli muscle lesions. The medical team suggested a cervical magnetic resonance imaging (MRI) examination; however, the patient\'s family opted out. Subsequently, the patient underwent wound debridement, which involved the extraction of a fragment of impaling wood. Two days after the procedure, the patient developed a fever and weakness of the shoulder and arm on the ipsilateral side. Following the process of re-education, the family provided consent for MRI examination. A subsequent surgical procedure was performed on the patient based on the MRI findings and clinical presentation. Residual wooden fragments were effectively extracted, resulting in positive progression of the patient\'s condition.
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  • 文章类型: Case Reports
    背景:髋臼后壁粉碎性骨折通常由高能量创伤引起,髋臼复杂的解剖结构使其治疗具有挑战性。然而,新鲜髋臼骨折合并股骨头坏死的治疗报道极为罕见。
    方法:一位57岁的男性,在车祸中受伤,表现为右髋部疼痛和活动受限。50岁时,患者被诊断为右股骨头缺血性坏死,行走时经历右髋部疼痛和跛行,开始保守治疗。
    方法:患者临床诊断为新鲜粉碎性髋臼后壁骨折和晚期股骨头坏死。
    方法:我们应用3D打印技术和计算机辅助虚拟手术技术进行术前规划,模拟骨折复位,并设计了个性化的骨板和螺钉,用于固定髋臼后壁。单阶段全髋关节置换术治疗股骨头坏死。
    结果:手术后1个月,他在步行者的帮助下开始行走,手术后6个月,髋臼后壁骨折有效愈合,让病人重返工作岗位。
    结论:3D打印技术在髋臼内固定和全髋关节置换术中的应用有助于骨折评估,有利于顺利手术,促进骨折复位和愈合,恢复髋关节功能,并确保高水平的安全性。
    BACKGROUND: Posterior wall comminuted fractures of the acetabulum are typically caused by high-energy trauma, and the complex anatomical structure of the acetabulum makes their treatment challenging. However, reports of the treatment of fresh acetabular fractures combined with femoral head necrosis are extremely rare.
    METHODS: A 57-year-old male, injured in a car accident, presented with right hip pain and limited mobility. At the age of 50, the patient was diagnosed with avascular necrosis of the right femoral head, experiencing right hip pain and a limp while walking, for which conservative treatment was initiated.
    METHODS: The patient was clinically diagnosed with fresh comminuted posterior wall acetabular fracture and late-stage femoral head necrosis.
    METHODS: We applied 3D printing technology and computer-assisted virtual surgical techniques for preoperative planning, simulated fracture reduction, and designed personalized bone plates and screws for fixation of the posterior wall of the acetabulum. A single-stage total hip arthroplasty was performed to treat femoral head necrosis.
    RESULTS: He began walking with the assistance of a walker 1 month after surgery, and at 6 months post-surgery, the acetabular posterior wall fracture had effectively healed, allowing the patient to return to work.
    CONCLUSIONS: The application of 3D printing technology in acetabular internal fixation and total hip arthroplasty is helpful for fracture assessment, facilitates smooth surgery, promotes fracture reduction and healing, restores hip joint function, and ensures a high level of safety.
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