Abstract

A 64-year-old woman was found lying lifeless on a sofa in her apartment with blood coming from her head. The woman was taken to hospital but died approximately 7 h later despite intensive care. When she was found in the apartment, her face was covered with a folded towel which exhibited two separate penetrating holes, each 5–6 mm in diameter, with adjacent soot and blood deposits. A ‘VeloDog’, .25 (6.35 mm) caliber revolver (Fig. 1) was found next to the body. The revolver cylinder contained three spent cartridges and two unfired rounds. A deformed projectile was discovered on the sofa where the body of the woman was lying. Police investigations could not determine how she had obtained the revolver. Relatives reported that she suffered from diabetes mellitus and alcoholism. No history of psychotic disorders or previous suicide attempts was reported. A suicide note was left on a table near her body in the apartment. Postmortem multislice computed tomography (pmMSCT) scans prior to medico-legal autopsy demonstrated a circular bony defect accompanied by a circular superficial injury of the outer table of the skull on the right temporal bone (Fig. 2a). An intracranial foreign body, which was interpreted as a projectile, was detected in the left temporal region (Fig. 2b). External examination revealed two small circular skin defects (measuring 3–4 mm in diameter each) surrounded by an abrasion margin and concentric rubor on the right temporoparietal region (Fig. 3). Neither soot nor gunpowder residue were deposited around these wounds. Consistent with the finding of pmMSCT scans, a circular superficial depression injury of the outer table was observed in the right temporal bone corresponding to the antero-superior wound (Fig. 4). A circular penetrating cranial defect of the outer table, measuring 6 mm in diameter, exhibited internal bevelling and corresponded to the postero-inferior wound. The wound track passed intracranially through anterior parts of the right temporal lobe, crossed the midline through both lateral ventricles and the corpus callosum, where intraventricular hemorrhage was observed, and continued through the left temporal lobe. The wound canal ended at the subarachnoidal space of the left temporal lobe where a deformed projectile was recovered (Fig. 5). The brain showed massive swelling (weight 1,690 g) and moderate epidural and subdural hematomas (EDH and SDH) were detected in the right temporal region. There was widespread subarachnoidal hemorrhage (SAH) particularly over the right cerebral hemisphere. The brainstem was uninjured. Apart from a fatty liver and chronic pancreatitis, no other gross pathology findings were noticed. Toxicological analysis of a femoral blood sample was negative. The cause of death was a cranial gunshot injury and the manner of death was classified as suicide. T. Hayashi (&) R. Gapert M. Tsokos S. Hartwig Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charite, University of Berlin, Turmstr. 21, Building N, 10559 Berlin, Germany e-mail: takahito@m2.kufm.kagoshima-u.ac.jp URL: http://remed.charite.de

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