Nomenclature for knot position in hanging A study of 200 cases.

Hanging is one of the common methods of committing suicide world wide. Position of the knot, in hanging cases is important as it determines the post-mortem findings of the head and face and can also be used to predict the expected autopsy findings. Although hanging has been described in forensic literature since ages, there has been no proper scientific nomenclature for classifying the position of knot in hanging cases. This paper describes a new nomenclature of exact knot position on the neck based on commonly used anatomical landmarks with self explanatory terms of classification, so that it can be understood and used by the autopsy surgeons and the pathologists with ease. In the present study 200 cases of hanging were studied retrospectively and position of knot is classified according to a newly described nomenclature. The new nomenclature classifies the position of knot into 6 major classes each of which are further subdivided into 3 subcategories thus making 18 different positions on each side of neck. The most common position of knot was found at occipitomastoid region (32%) and the least common position being at mental region (2%).

Medicolegal importance of inca bone in forensic.

Skull is usually available human bone for establishing personal identity. Presence of Inca bone in human skull is one such feature that may be identified on radiological examination and if earlier recorded help in establishing the identity of deceased. Complete division of membranous and cartilaginous part of occipital bone by a transverse suture extending between the two lambdoid sutures at the level of highest nuchal line above the external occipital protuberance, results in rare cranial variation presenting as Inca bone.During medicolegal examination of one male skull at Madhya Pradesh Medicolegal Institute Bhopal, presence of Inca bone was found. The interparietal bone is formed by a part of the squamous occipital bone bounded by two lambdoid sutures on two sides and additional longitudinal suture on both sides between lambdoid suture and external occipital protuberance forming diamond shaped Os Incae Centrale that can also be considered as intra-occipital bone. Such rare findings have significant anthropological and embryological basis. Specific anatomical feature if earlier documented in the clinico-radio-pathological reports of the deceased provides opportunity for establishing the identity.

Adult choroid plexus papilloma: cause of sudden death.

Choroid plexus papilloma (CPP) is a rare, benign neoplasm, relatively more common in childhood. It is associated with signs and symptoms of increased intracranial pressure, frequently in association with obstructive hydrocephalus. CT and MRI are the investigations of choice and are diagnostic. Sudden deaths have been reported, but are very unusual. A 41 year old male was brought for medico-legal autopsy examination on ground of sudden death. He was reported to have headaches over a long period of time. On autopsy examination, massive sub-arachnoid hemorrhage was seen on both the cerebral hemispheres and cerebellum. A cyst measuring about 1 cm diameter was found in choroid plexus of right lateral ventricle. On histopathological examination, it was found to be a choroid plexus papilloma. Calcification was also evident in the papilloma. From medico-legal aspect, the present case reveals an unusual cause for sudden death in an adult male. The pathology could have been diagnosed easily by CT scan or MRI. When diagnosed, it has good survival rate, the morbidity depending on the extent of pathological effects. The present case was likely to have survived having minimal effects with appropriate treatment had he been diagnosed. The pathology is rare and a suspicion for this pathology in the adult male was not expected, but a CT scan to investigate chronic headache was warranted. Absence of such a suggestion leading to death, which could have been preventable, is sufficient ground for charge of professional negligence.

Delayed death in a case of attempted strangulation mechanism of cerebral thrombosis and infarction -A case report.

Throttling is usually a homicidal act and generally the assailant continues the compression until the victim is dead. Pressure applied on the neck for about 3 -4 minutes consistently or more, is considered to be sufficient to cause death; the survival time depending upon the degree and duration of compression of the neck. The death may either be instantaneous or may be delayed for a few hours to a few days but in rare circumstances, the victim may survive, if rescue measures and treatment are promptly instituted. One such case of a male aged about 60 years, who was hospitalized after attempted manual strangulation for about 19 days and died thereafter, is being discussed. Medico legal autopsy findings of such a case are being evaluated in the light of existing literature.