An Unusual Death From Penetrating Cranial Trauma: The Importance of Investigating the Primary Scene of Injury

Area of Science:

• Forensic Pathology
• Neuropathology
• Trauma Analysis

Background:

• A 65-year-old man with hypertension and coronary artery disease died 6 days after a fall.
• Autopsy revealed unexplained penetrating skull trauma with significant internal brain damage.

Purpose of the Study:

• To investigate the etiology of a penetrating cranial injury with delayed death.
• To determine the manner of death by identifying the injury mechanism and object.

Main Methods:

• Autopsy examination of the deceased.
• Medicolegal death investigation, including interviews and primary scene investigation.
• Photography of the injury and the implicated object.

Main Results:

• A circular defect in the frontal bone indicated penetrating trauma.
• Cerebral laceration and organizing subdural hemorrhage were present.
• The primary scene investigation identified the injury scenario and the causative object.

Conclusions:

• Delayed death cases require thorough investigation of the primary injury scene.
• Penetrating cranial injuries can cause extensive internal damage with minimal external signs.
• Accurate certification of the manner of death depends on elucidating the injury etiology.