Forensic Pathology Reviews

306 Pages·2005·9.184 MB·English

by  Burkhard Madea MD (auth.), Michael Tsokos MD (eds.)

Forensic Pathology Reviews
F P R
ORENSIC ATHOLOGY EVIEWS
Michael Tsokos, MD,SERIES EDITOR
FORENSIC PATHOLOGY REVIEWS, VOLUME 3, edited by Michael Tsokos, 2005
FORENSIC PATHOLOGY REVIEWS, VOLUME 2, edited by Michael Tsokos, 2005
FORENSIC PATHOLOGY REVIEWS, VOLUME 1, edited by Michael Tsokos, 2004
F
ORENSIC
P
ATHOLOGY
R
EVIEWS
Volume 2
Edited by
Michael Tsokos,
MD
Institute of Legal Medicine, University of Hamburg,
Hamburg, Germany
© 2005 Humana Press Inc.
999 Riverview Drive, Suite 208
Totowa, New Jersey 07512
humanapress.com
For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana
at the above address or at any of the following numbers: Tel: [phone]; Fax: [phone]; E-mail:
[email protected]; Website at humanapress.com
All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any
form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without
written permission from the Publisher.
All articles, comments, opinions, conclusions, or recommendations are those of the author(s), and do not
necessarily reflect the views of the publisher.
This publication is printed on acid-free paper. (cid:39)
ANSI Z39.48-1984 (American National Standards Institute)
Permanence of Paper for Printed Library Materials.
Production Editor: Robin B. Weisberg
Cover design by Patricia F. Cleary
Cover illustrations from Fig. 1, Chapter 10, “Arthropods and Corpses,” by Mark Benecke; Fig. 7, Chapter 2,
“Infant and Early Childhood Asphyxial Deaths: Diagnostic Issues,” by Roger W. Byard and Michael Tsokos;
Fig. 9, Chapter 8, “Sudden, Unexpected Death Related to Viral Myocarditis: A Survey of Histological,
Immunohistochemical, and Molecularpathological Methods for the Postmortem Diagnosis,” by Reinhard
Dettmeyer and Burkhard Madea; Fig. 1, Chapter 2, “Skull Injuries Caused by Blows With Glass Bottles,”
by Burkhard Madea, Peter H. Schmidt, Eberhard Lignitz, and Stephan A. Padosch; and Fig. 3, Chapter 3,
“Primary Cerebral Neoplasms as a Cause of Sudden, Unexpected Death,” by Jakob Matschke.
Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the
internal or personal use of specific clients is granted by Humana Press, provided that the base fee of US
$25.00 per copy is paid directly to the Copyright Clearance Center (CCC), 222 Rosewood Dr., Danvers
MA01923. For those organizations that have been granted a photocopy license from the CCC, a separate
system of payment has been arranged and is acceptable to the Humana Press. The fee code for users of the
Transactional Reporting Service is 1-58829-415-3/05 $25.00.
Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1
eISBN 1-59259-872-2
Library of Congress Cataloging-in-Publication Data
Forensic pathology reviews, Volume 2 / edited by Michael Tsokos.
p. cm.
Includes bibliographical references and index.
ISBN 1-58829-415-3 (alk. paper)
1. Forensic pathology. I. Tsokos, Michael.
RA1063.4.F675 2004
614.1—dc22
2003027503
Dedication
To my son Titus for the joy and fun he brings to my life day by day.
—Michael Tsokos, MD
v
Series Introduction
Over the last decade, the field of forensic science has expanded enormously.
The critical subfield of forensic pathology is essentially based on a transverse,
multiorgan approach that includes autopsy, histology (comprising neuro-
pathological examination), immunohistochemistry, bacteriology, DNA
techniques, and toxicology to resolve obscure fatalities. The expansion of the
field has not only contributed to the understanding and interpretation of many
pathological findings, the recognition of injury causality, and the availability of
new techniques in both autopsy room and laboratories, but also has produced
specific new markers for many pathological conditions within the wide variety
of traumatic and nontraumatic deaths with which the forensic pathologist deals.
TheForensic Pathology Reviewsseries reflects this expansion and provides
up-to-date knowledge on special topics in the field, focusing closely on the
dynamic and rapidly growing evolution of medical science and law. Individual
chapters take a problem-oriented approach to a central issue of forensic pathology.
Acomprehensive review of the international literature that is otherwise difficult
to assimilate is given in each chapter. Insights into new diagnostic techniques
and their application, at a high level of evidential proof, will surely provide helpful
guidance and stimulus to all those involved with death investigation.
It is hoped that this series will succeed in serving as a practical guide to
daily forensic pathological and medicolegal routine, as well as provide
encouragement and inspiration for future research projects. I wish to express my
gratitude to Humana Press for the realization of Forensic Pathology Reviews.
Michael Tsokos, MD
vii
Preface
When asked by the Prussian king, “So what is new in heaven?” Friedrich
Wilhelm August Argelander (1799–1875), astronomer at the University of Bonn,
Germany, answered “Does his majesty already know what is old?” This second
volume of Forensic Pathology Reviews is intended to complement rather than
replace the classical textbooks of forensic pathology by providing those interested
in death investigation with the state-of-the-art accounts of special topics from
various fields of forensic pathology and death scene investigation.
Chapter 1 examines the medicolegal aspects of death resulting from star-
vation (i.e., as a result of deliberate withholding of food from infants). The author
provides deep insight into how an expert opinion may be formed on the degree
and duration of starvation by applying different classification systems of protein-
energy malnutrition to such cases. In Chapter 2, the authors present a fundamental
and detailed look at the pathological features of head injuries that are inflicted
by glass bottles. The presentation of the characteristic morphological findings in
such cases is complemented by relevant experimental biomechanical data and
valuable guidelines for practical casework. Chapter 3 devotes attention to the
current understanding of the clinical and pathological features of primary cerebral
neoplasms, according to the World Health Organization’s classification scheme.
In particular, the role of these unique tumors as a cause of sudden, unexpected
death is emphasized. Chapter 4 concerns obesity, one of the pre-eminent health
issues in the Western world. In the United States, approximately 300,000 adult
deaths can be attributed annually to obesity-related complications. The authors
provide the reader with an exhaustive overview concerning aspects of the obesity
epidemic, definitions and measurements of obesity, and risk factors, as well as
other issues relevant to the forensic pathologist, such as premature death relating
to obesity, pathologies, and causes of death.
Chapter 5 takes a comprehensive look at what the pathologist may encounter
when dealing with infant and early childhood asphyxial deaths. The authors point
to the differential diagnosis between inflicted (homicidal) and accidental
asphyxias, airway obstruction from natural causes, foreign body impaction, and
sudden infant death syndrome (SIDS). In Chapters 6 and 7, highly interesting
topics related to suicide are discussed. Chapter 6 deals with planned and unplanned
ix
Preface x
complex suicides. In addition to a complete literature review of research published
to date, the criminological points of view in association with the forensic
pathological investigation of complex suicide cases are presented. A thorough
examination of the pathological features of occupation-related suicides is provided
in Chapter 7. The authors elucidate in detail the problems that may arise in the
medicolegal interpretation of occupation-related suicides and provide practical
guidelines for comprehensive and conclusive forensic casework.
Chapter 8 covers the subject of viral myocarditis in forensic autopsy cases.
Cases of sudden, unexpected death represent a substantial proportion of forensic
autopsy cases, and postmortem studies suggest that myocarditis accounts for up
to 20% of all such cases. The diagnosis of viral myocarditis may present difficulties
when solely based on conventional histological findings. The authors provide
the reader with a survey of the latest immunohistochemical and molecular-
pathological techniques that are appropriate to prove lethal myocarditis in cases
with a high index of suspicion of an underlying viral myocarditis, but are not
supported by traditional histological findings.
Chapter 9 comprehensively examines some curious phenomena that may
occasionally be observed at a scene of death (e.g., hiding, covering, and
undressing). Such phenomena generally appear dubious at first sight and may
raise suspicion of a crime, even by experienced observers. These behavioral
patterns that take place in agony, when the conscious, rational control of thoughts
is fading, and the associated behaviors, are elucidated in detail. The knowledge
of these peculiar behavioral patterns is most useful to all those involved in death
scene investigation in order to correctly interpret the scene and to exclude
involvement of a third party.
Chapter 10 addresses the subject of forensic entomology. A thorough
understanding of the numerous ways in which arthropod evidence can be applied
not only to the determination of the postmortem interval, but also to the proof of
neglect of elderly or children, is essential for every forensic pathologist and
medical examiner, respectively. Chapter 11 deals with the interpretation of
toxicological findings in the setting of an entire death investigation, including a
comprehensive presentation of potential pitfalls in toxicology testing that are
always of concern.
In Chapter 12, thorough information about long-term effects of anabolic-
androgenic-steroid abuse and the associated pathological findings is provided.
Since recent studies suggest that 3–12% of male adolescents and about 1–2% of
female adolescents use anabolic-androgenic-steroids at some time during their
lives, this issue is of considerable importance to everyone involved in medicolegal
investigations. Chapter 13 devotes attention to the autopsy findings of
xi Preface
subendocardial hemorrhages. The author gives a detailed review of the latest
literature with special reference to the underlying pathophysiological mechanisms
and the significance of subendocardial hemorrhages in forensic autopsy practice
as a vital reaction.
This book is the result of many experts in forensic pathology coming together
to share their expertise. I wish to express my deepest gratitude to all of the
contributors for making their practical and scientific knowledge accessible to a
broad international readership.
Michael Tsokos, MD