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Biomedical subjects

Anny Sauvageau

Publications and source records attributed to Anny Sauvageau.

16 recordsLinked to original sources
PubMed2007

Suicidal decapitation using a tractor loader: a case report and review of the literature.

In forensic practice, decapitated bodies are predominantly associated with decapitation by wheels of trains or with postmortem dismemberment following homicide. In the suicidal context, decapitation accounts for less than 1% of total suicide. Apart from decapitation by trains, other encountered methods involve suicidal hanging and vehicle-assisted ligature suicide. Reported here is a unique case of suicidal decapitation in a 45-year-old man using a tractor loader at the foot of a silo, on his farm. The head was recovered in the loader and there were several impact spots from the loader as well as blood on the silo wall. The autopsy revealed a complete decapitation wound with the severance plane located between the third and fourth cervical vertebra. A 1.5 cm wide abrasion on the anterior part of the neck and abrasions under the chin were noted. This very unique case of intentional suicidal decapitation is the first reported case of a planned system intended to create decapitation outside the unique case of homemade guillotine and the more common decapitation by train.

Accidents, Home↗
PubMed2007

Brain arteriovenous malformation and its implication in forensic pathology.

Despite the fact that brain arteriovenous malformations (BAVMs) are a possible cause of sudden and unexplained death, very few papers have discussed their importance in the forensic context. BAVMs consist of tangled masses of tortuous arteries and veins devoid of intervening capillaries that frequently extend from brain parenchyma into the subarachnoid space. Apart from BAVMs, three major groups of vascular malformations of the brain are known: cavernous hemangioma, venous angioma, and capillary telangiectasia. BAVMs and cavernous hemangioma often cause hemorrhages, while venous angioma and capillary telangiectasia are typically asymptomatic. Presented here is the case of a 14-year-old girl who died from a ruptured BAVM. The present case is a reminder that the forensic pathologist should be able to recognize BAVMs and to differentiate it from other types of vascular malformations. Although rare, it is a cause of sudden death not to be overlooked, especially in children.

Adolescent↗
PubMed2006

Delayed deaths after vascular traumatism: two cases.

During expert testimony in court, forensic pathologists are often asked to estimate the length of survival following fatal injuries. Though it is impossible to be precise, fatal vascular trauma survival times are generally considered short. We here report two unusual cases of delayed deaths, one following homicidal stabbing of the heart and the other by suicidal cutting of the neck. In those two cases, investigation clearly provided evidence of prolonged survival: slightly more than 2h for the first case and about 8h for the second. Relevant literature is revised and physiopathological hypotheses are discussed.

Aged↗
PubMed2006

Fatal asphyxia by a thyroglossal duct cyst in an adult.

Thyroglossal duct cysts arise from remnants of embryonic thyroglossal duct that connects the foramen cecum at the base of the tongue to the thyroid gland. The remnants enlarge secondary to secretions from the epithelial lining. Usually, thyroglossal cysts present as non-tender masses. However, they may also become infected, produce fistulas or give hoarseness and dysphagia. Rarely, especially if the mass is located at the base of the tongue, airway obstruction and dyspnea can ensue. This unusual presentation has been mainly seen in very young children and has caused death in about half of these cases. Nevertheless, in the adult population, very few cases of airway obstruction by thyroglossal duct cysts have been reported, only one being fatal. We present the case of a 55-year-old man who died from fatal asphyxia caused by a thyroglossal cyst.

Asphyxia↗
PubMed2006

Choking on toilet paper: an unusual case of suicide and a review of the literature on suicide by smothering, strangulation, and choking.

While reports of suicide by smothering and strangulation are common, suicide by choking is far more rare. In addition to the act being difficult to carry out, suspected cases are not easily distinguished from accidental or homicidal deaths. Here, we present a case of suicide by choking on toilet paper in a patient with a long history of schizophrenia. The case was ruled a suicide based on the patient having been witnessed in a previous unsuccessful attempt of the same act.

Airway Obstruction↗
PubMed2006

Aqua-eroticum: an unusual autoerotic fatality in a lake involving a home-made diving apparatus.

The term Aqua-eroticum was first introduced in 1984 by Sivaloganathan to describe the unusual autoerotic death of a man using submersion as an asphyxia method. This was the first case of that kind, and since then, no other case of autoerotic submersion has been reported, nor other autoerotic fatality in open water. Here we report the case of a 25-year-old man, nude under a home-made plastic body suit, overdressed for the season with winter clothes and restrained by complex bondage. He was submersed, tied underwater to a boat and was using a home-made diving apparatus for air supply. Death was ruled as accidental autoerotic asphyxia from rebreathing, caused by the faulty air-supply device.

Accidents↗
PubMed2006

Autoerotic deaths in the literature from 1954 to 2004: a review.

Autoerotic death by hanging or ligature is a method of autoeroticism well known by forensic pathologists. In order to analyze autoerotic deaths of nonclassic hanging or ligature type, this paper reviews all published cases of autoerotic deaths from 1954 to 2004, with the exclusion of homicide cases or cases in which the autoerotic activity was not solitary. These articles were obtained through a systematic Medline database search. A total of 408 cases of such deaths has been reported in 57 articles. For each case, the following characteristics are presented here: sex, age, race, method of autoerotic activity, cause of death, and location where the body was found. Autoerotic death practioners were predominantly Caucasian males. Victims were aged from 9 to 77 years and were mainly found in various indoor locations. Most cases were asphyxia by hanging, ligature, plastic bags, chemical substances, or a mixture of these. Still, atypical methods of autoerotic activity leading to death accounted for about 10.3% of cases in the literature and are classified here into five broad categories: electrocution (3.7%), overdressing/body wrapping (1.5%), foreign body insertion (1.2%), atypical asphyxia method (2.9%), and miscellaneous (1.0%). All these atypical methods are further discussed individually.

Age Distribution↗
PubMed2006

Female autoerotic deaths--still often overlooked: a case report.

Female autoerotic deaths are less common than male ones and usually present in a less obvious way. Thus, such deaths can be easily overlooked, even by senior investigators, if the latter are not fully aware of the particularities of female autoerotic cases. We present the case of a 34-year-old woman, found dead in her apartment, with several foreign body insertions and a dog leash around the neck. Despite the great experience of the investigative team, autoerotic death was not considered at first. This case illustrates the importance of forensic teams having knowledge of the particularities of female autoerotic deaths.

Accidents↗
PubMed2005

Unusual sudden death: two case reports of hemorrhage by rupture of varicose veins.

Although varicose veins are frequent, they are rarely considered lethal. Still, rupture of a varicosity can result in significant and even fatal hemorrhage. External hemorrhage is an unusual complication of this common venous pathology. Reported here are 2 cases of severe external hemorrhage resulting from the perforation of a varicose vein.

Aged↗
PubMed2005

An unusual case of suicide by broken glass pierced through the buttocks: a case report.

Suicidal stabbing to the back and buttocks is very unusual due to the limited accessibility of that region to the victim's hand. The following case report describes a 38-year-old man, known for depression and suicidal ideation, who was found deceased in his home after tearing his right internal iliac artery by stabbing himself through the buttock with a piece of glass from a broken beer bottle. The literature on suicidal stabbing, particularly focusing on the type of weapon and localisation of wounds, is reviewed.

Adult↗
PubMed2005

1. Fatal acute hepatitis in infectious mononucleosis in a forensic setting: a case report.

Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.

Acute Disease↗
PubMed2005

Arrhythmogenic right ventricular cardiomyopathy/dysplasia mimicking rape homicide: a case report.

Arrhythmogenic right ventricular cardiomyopathy (ARVC), also known as arrhythmogenic right ventricular dysplasia, is a known cause of sudden unexplained death in young, otherwise healthy adults. In the forensic setting, several cases of fatal ARVC have been reported, mostly occurring during physical exercise. However, a very few cases present where the death scene is mistaken for a homicide. We report here the case of a 23-year-old woman, found dead, lying in the snow on an isolated property. The woman's genitals were exposed, with her trousers down over her thighs. Rape homicide was strongly suspected, but autopsy findings proved otherwise.

Adult↗
PubMed2005

Suicide by inhalation of carbon monoxide in a residential fire.

Fire deaths are usually accidental, but atypical cases of homicide or suicide have been described. In suicide by fire, the only method reported by several authors consists of self-immolation. We present here the unusual case of an adult female who committed suicide by waiting in the living room after setting fire to her bedroom. The autopsy revealed smoke inhalation and the toxicological analysis revealed carboxyhemoglobin levels of 67%. Very few cases of suicide by fire not of the self-immolation type have been reported, and all have been anecdotal. A review of the literature is presented and a new term, "suicide by inhalation of carbon monoxide in a fire," is proposed for such cases.

Administration, Inhalation↗
PubMed2003

Induction of astrocytic cyclooxygenase-2 in epileptic patients with hippocampal sclerosis.

Induction of cyclooxygenase-2 (COX-2) has been described in a wide range of neurological diseases including animal models of epilepsy. The present study was undertaken to assess COX-2 expression in hippocampal biopsies from patients with therapy-refractive temporal lobe epilepsy (TLE). For this purpose, hippocampal CA1 subfield was dissected from epileptic patients with (n=5) or without (n=2) hippocampal sclerosis (HS). COX-2 expression was investigated using immunohistochemistry and semi-quantitative RT-PCR. COX-2 immunoreactivity in TLE patient material in the absence of HS was restricted to a few neurons of the hippocampus. In the presence of HS, on the other hand, a significant induction of astrocytic COX-2 immunoreactivity associated with a concomitant increase in the steady-state level of COX-2 mRNA was observed in the CA1 subfield. These findings suggest that induction of astrocytic COX-2 is implicated in the pathogenesis of HS in TLE and is consistent with the previous findings of increased concentrations of prostaglandins in the cerebrospinal fluid of these patients.

Adolescent↗
PubMed2002

Increased expression of "peripheral-type" benzodiazepine receptors in human temporal lobe epilepsy: implications for PET imaging of hippocampal sclerosis.

Increased binding sites for "peripheral-type" benzodiazepine receptor (PTBR) ligands have been described in a wide range of neurological disorders including both human and experimental epilepsy. This study was undertaken to assess PTBR expression in relation to the presence of hippocampal sclerosis in human temporal lobe epilepsy (TLE). For this purpose, hippocampal CA1 subfields were dissected from surgical samples from patients with therapy-refractive TLE with (n = 5) or without (n = 2) hippocampal sclerosis and from age-matched nonepileptic postmortem controls (n = 5). PTBR expression was assessed by immunohistochemistry and reverse-transcription polymerase chain reaction. Receptor sites were evaluated using an in vitro binding assay and the selective PTBR ligand [3H]PK11195. Epileptic patients with hippocampal sclerosis showed increases in PTBR binding sites, immunoreactivity, and mRNA expression compared to both nonsclerotic TLE patients and postmortem nonepileptic controls. Induction of PTBR expression and binding sites were directly correlated with the presence of hippocampal sclerosis and the accompanying reactive gliosis.

Epilepsy, Temporal Lobe↗