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NCJRS Abstract

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NCJ Number: 229296 Find in a Library
Title: Walk and Die: An Unusual Presentation of Head Injury
Journal: Journal of Forensic Sciences  Volume:54  Issue:6  Dated:November 2009  Pages:1466-1469
Author(s): Abigail E. Veevers, M.B., Ch.B.; William Lawler, M.B., Ch.B., M.D.; Guy N. Rutty, M.D., M.B.B.S.
Date Published: November 2009
Page Count: 4
Type: Case Study
Format: Article
Language: English
Country: United States of America
Annotation: This paper reports on three cases of deaths in young adult men following blunt trauma to the head and face, after which the victims walked away from incident before dying a short distance away; internal examinations at autopsies showed limited findings with no structural explanation for the deaths.
Abstract: Based on autopsy findings in these cases, the authors hypothesize that rather than a single mechanism or macroscopic finding that explains the causes of these deaths, the deaths were related to the findings of a combination of malignant brain swelling without herniation, cellular neuronal, and cerebral cardiorespiratory center dysfunction, resulting in posttraumatic apnea and fatal cardiac arrhythmia, which acted together to produce the atypical scenarios in these cases. Of these hypothesized mechanisms, the authors favor the mechanisms that underlie so-called “postexercise peril.” Dinsdae et al. described the phenomenon of “postexercise peril.” In their observations of 10 healthy men who underwent exercise testing, they report the rise in catecholamine levels, not only as a response during the exercise period, but also in the immediate postexercise period. A 10-fold increase of norepinephrine over baseline could have profound cardiac effects, especially in those with pre-existing cardiac disease. It could be hypothesized that persons with undiagnosed cardiac arrhythmogenic syndromes, which have been diagnosed as causes of sudden unexpected adult death, could place these individuals at increased risk of death under the circumstances of “post exercise peril.” This natural physiological response could have placed the individuals in the cases cited at increased risk of death under the circumstances described. In addition, blood potassium concentrations also alter during exercise, increasing and then rapidly decreasing in the postexercise period. The combination of raised catecholamines and decreasing potassium levels in the presence of pre-existing cardiac disease may result in fatal cardiac arrythmias. 17 references
Main Term(s): Criminology
Index Term(s): Aggravated assault; Assault and battery; Autopsy; Death investigations; Forensic sciences; Investigative techniques
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