CT Evaluation of Cerebral Atrophy in Medicolegal Opinions in Murder Cases

Abstract

This study evaluated the prevalence and intensity of cerebral atrophic lesions, considering age, in murderers subjected to CT as an element of medicolegal assessment in the course of legal proceedings in manslaughter cases. Brain CT was performed in 65 murderers (59 men, six women, aged 15–72 years) by court order in the course of criminal proceedings. The width of the ventricular system, distance between skull lid bones and width of the subarachnoid space were measured and values of indices such as: frontal horn index, Evans index, ventricular index, cella media Schiersmann index and Huckman number were calculated. Mean values of measurements and indices were calculated for both the whole group examined and separately for four age groups (up to 20, 21–40, 41–60 and from 61). Results were compared to norms of physiological brain ageing according to Meese with Kuśmiderski's modifications. In the murderers examined, cortical atrophy exceeding physiological values was observed only in the group up to 20 years old. Subcortical atrophy exceeding physiological values was observed in groups up to 20 and to a lesser extent 21–40 years old. Width of the third ventricle and cella media index were within the limits for normal brain ageing in all groups. Values of frontal horn index and Huckman number, corresponding to frontal lobe atrophy, exceeded physiological values in groups up to 20 and to a lesser extent 21–40 years old. Cerebral atrophy, particularly subcortical frontal lobe atrophy exceeding physiological values, indicating characteropathy as one of the potential reasons for aggressive behaviour, was statistically significant in people up to 40 years old, however in people more than 40 years old it did not differ from values regarded as normal.