Fatal spontaneous subdural bleeding due to neonatal giant cell hepatitis: a rare differential diagnosis of shaken baby syndrome.

A 7-week-old girl showed vomiting after feeding, facial pallor, loss of muscle tone and respiratory depression. An emergency doctor performed successful resuscitation and after arrival in hospital, cranial ultrasound showed left-sided subdural hemorrhage, cerebral edema with a shift of the midline, and a decrease in cerebral perfusion. Ophthalmologic examination showed retinal hemorrhage.

Lethal pedestrian--passenger car collisions in Berlin. Changed injury patterns in two different time intervals.

To expand the passive safety of automobiles protecting traffic participants technological innovations were done in the last decades. Objective of our retrospective analysis was to examine if these technical modifications led to a clearly changed pattern of injuries of pedestrians whose death was caused by the accidents. Another reduction concerns the exclusion of injured car passengers--only pedestrians walking or standing at the moment of collision were included.

A series of hospital homicides.

Patient deaths in hospitals due to medical staff are very rare. In the autumn of 2006, preliminary proceedings were initiated against a nurse on account of an overdose of medication leading to death, administered during her care of the patient. In the course of these proceedings, exhibits relating to the deaths of a total of 13 patients who had died due to chemical-toxicological causes were reviewed.

Detection of arterial bleeding points in basilar subarachnoid hemorrhage by postmortem angiography.

The most common cause of basal cerebral subarachnoid hemorrhage (SAH) is rupture of a cerebral artery aneurysm, but most reported series of SAH include cases where no aneurysm could be found. This would have no forensic relevance if all basal SAH would result from spontaneous ruptures of pathological blood vessels, but the situation is more complex because traumatic ruptures of otherwise normal cerebral arteries may be the only intracranial result of an injury. From the gross appearance, these two types of basal SAH cannot be distinguished.

External injury marks (wounds) on the head in different types of blunt trauma in an autopsy series.

The localization, length and number of deep scalp wounds caused by falls on a flat surface (n = 203), falls down stairs (n = 51) and from blows (n = 51) were examined in a comparative analysis of 305 deaths. This confirmed the common finding in forensic literature that head injuries from blows occur more often (55% of cases) above the so-called hat-brim line (= greatest horizontal head circumference) than injuries from falls on a flat surface. On the other hand, around one third of the wounds caused by falls were located above this line.

Bone finds: a challenge to forensic science.

The study presented here is based on 176 forensic dental reports compiled between 1993 and 2001. The bulk of the research took place in 1997, when major construction at Potsdamer Platz and Lehrter Bahnhof in central Berlin required the excavation of considerable quantities of earth. As building proceeded here, at 'Europe's biggest construction site', it revealed not only a large number of long bones, but also a great many skulls and skull fragments.

Forensic importance of aspiration.

The problems of assessment of aspiration (foreign bodies, stomach contents, food material) in forensic practical work are well-known, especially if 'suffocation due to aspiration' is considered to be the cause of death (or a concurrent cause of death). In the last 4 years (1998-2001) in the Department of Legal Medicine of the Free University, Berlin, 14 deaths with massive aspirations were investigated. The lethal aspiration cases consisted of seven men and five women between 55 and 91 years old, as well as two children (boy 6 years and girl 19 months old).

Postmortem radiological investigation of bridging vein ruptures.

In the usual method of brain removal in forensic autopsies, the upper bridging veins were invariably torn. There are several types of head injuries, in which ruptures of these vessels are the predominant intracranial injury. For the past 5 years we have investigated nearly all cases of lethal head injuries by a simple X-ray method (axial X-ray after instillation of contrast material into the superior sagittal sinus).