An unusual death by transcranial stab wound: homicide or suicide?

Penetrating stab wounds of the brain are uncommonly seen in modern times and occur almost exclusively in homicides. We report an unusual death by self-stabbing. A 24-year-old man was found dead at home, the handle of a kitchen knife protruding from his forehead. Data such as the psychiatric history of the victim, the multiplicity and site of wounds, the implement used, the presence of hesitation, and defense wounds were studied to elucidate the manner of death, and the suicidal nature of the event was established after police investigation. Atypical injuries require a careful forensic investigation, and medico-legal aspects of the differentiation between homicide and suicide are discussed in this particular case. A review of the literature revealed few cases of suicidal transcranial stab wounds.

Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes.

We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.

[Chemical submission: a literature review]. / La soumission chimique: une revue de la littérature.

The aim of this review is to describe the present knowledge about chemical submission. The number of scientific publications on this phenomenon has increased over the last 10 years. Perpetrators choose drugs which act rapidly, produce desinhibition, sedation, and anterograde amnesia during the abuse. Ethanol and benzodiazepines are the most frequently used. A few drugs, including flunitrazepam and gamma-hydroxybutyric acid (GHB), have received widespread media coverage. Toxicological investigations on blood, urine or hair samples allow to detect the substance used. Every effort should be made to collect appropriate specimens as quickly as possible. Gas chromatography-mass spectrometry is at present the most appropriate analytical method to detect these drugs in a biological specimen.

Homicide in Tours (Indre-et-Loire, France): a four-year review.

This retrospective study examined homicides in two French departments located in the West of France (Indre-et-Loire and Loir-et-Cher) for a four-year period from 2000 to 2003. During this period 63 homicidal deaths were investigated at the Institute of Forensic Science of Tours (Indre-et-Loire). There were 45 male and 18 female victims with an average homicide rate of 1.55 per 100,000 persons. The mean age of the victims was 42 years-old. Forty-five assailants were identified; their mean age was 38 years-old. The most common method of homicide was the use of firearms (40% of the cases), followed by blunt-force injury (36%) and sharp-force injury (16%). 51% of the victims knew their assailant, a family member in 26% of the cases. Spousal homicides occurred in 16% of the cases. Dyadic death occurred in six cases. A review of the literature compares these findings to other populations.

Plastic bag asphyxia--a case report.

Suicides due to plastic bag asphyxia have been reported in the literature but remain unusual. The circumstances of such deaths are reviewed and illustrated by the case of a 32-year-old male who was found dead in a lorry cab. The remarkable point is that the victim followed instructions from an American movie he had watched. This case emphasizes the importance of the investigation to determine the manner of death.