RESUMO
Self-inflicted stab injury to the skull, particularly in the neurocranium, is a rare method used to commit suicide. Herein is presented a case of a 26-year old woman with a temporal wound found by her partner in their home. No weapon was found in the approximate environment and the victim said that she fell. A CT scan performed at admission to the emergency room was interpreted as being compatible with injury from falls. A second CT scan in a neurosurgical unit suggested a cranio-cerebral injury from a sharp object; aggression was suspected. The discording elements led to an interview with a psychiatrist and diagnosis of attempted suicide through the action of a knife in the context of severe depression. This is a rare case that implicates a depressive woman and stabbing directly to the neurocranium.
Assuntos
Depressão/psicologia , Fraturas Cranianas/diagnóstico por imagem , Tentativa de Suicídio , Lobo Temporal/lesões , Ferimentos Perfurantes/diagnóstico por imagem , Adulto , Transtorno Bipolar/diagnóstico , Seio Cavernoso/diagnóstico por imagem , Seio Cavernoso/lesões , Feminino , Humanos , Paresia/etiologia , Hemorragia Subaracnóidea/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The hymeneal examination is often considered as the key of the gyneacological examination of a young girl victim of sexual assault, mainly because the concept of penetration is important under the French criminal code. However, the amount medical literature related to this topic is poor. The hymen examination must be conducted under strict conditions, by qualified personnel and as soon as possible after the alleged assault.The only kind of anomaly that can confirm a penetration is an injury to the posterior hymen extending up its base. The sensitivity of this sign is, however, low and its absence does not suggest that of penetration. A vaginal penetration does not always break the hymen, especially among adolescents. Moreover, the hymen can heal and thus it makes the examination difficult when it occurs a long time after the facts. Examination of the hymen is rarely the decisive factor in the forensic assessment of a young victim of sexual assault.