Biomedical subjects

Thomas Plattner

Publications and source records attributed to Thomas Plattner.

9 recordsLinked to original sources

PubMed2007

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings.

Based on only one objective and several subjective signs, the forensic classification of strangulation incidents concerning their life-threatening quality can be problematic. Reflecting that it is almost impossible to detect internal injuries of the neck with the standard forensic external examination, we examined 14 persons who have survived manual and ligature strangulation or forearm choke holds using MRI technique (1.5-T scanner). Two clinical radiologists evaluated the neck findings independently. The danger to life was evaluated based on the "classical" external findings alone and in addition to the radiological data. We observed hemorrhaging in the subcutaneous fatty tissue of the neck in ten cases. Other frequent findings were hemorrhages of the neck and larynx muscles, the lymph nodes, the pharynx, and larynx soft tissues. Based on the classical forensic strangulation findings with MRI, eight of the cases were declared as life-endangering incidents, four of them without the presence of petechial hemorrhage but with further signs of impaired brain function due to hypoxia. The accuracy of future forensic classification of the danger to life will probably be increased when it is based not only on one objective and several subjective signs but also on the evidence of inner neck injuries. However, further prospective studies including larger cohorts are necessary to clarify the value of the inner neck injuries in the forensic classification of surviving strangulation victims.

Adult↗

PubMed2006

Gas embolism following intraosseous medication application proven by post-mortem multislice computed tomography and autopsy.

The post-mortem use of modern imaging techniques such as multislice computed tomography (MSCT) is becoming increasingly important as an aid for conventional autopsy. This article presents a case of a 4-month-old boy who died from sudden infant death syndrome (SIDS) with intravascular gas after an intraosseus medication application documented by post-mortem MSCT. It is most likely that the gas entered the body during resuscitation. This case emphasises the advantage of post-mortem imaging as a complementary aid for the autopsy. We conclude that during emergency treatment, the medical staff should be aware of the possibility of causing a gas embolism following intraosseus medication. Resuscitation with an inserted, disconnected intraosseous needle should be avoided.

Autopsy↗

PubMed2006

The deadly broomstick: an unusual missile injury to the neck.

A 51-year-old man was struck by the tip of a broomstick weighing 1000 g at the left side of the neck, upon which he collapsed. Intense but delayed cardiopulmonary resuscitation restored the circulation roughly 30 minutes after the incident. Upon admittance to a nearby hospital, an extensive hypoxic cerebral damage was diagnosed. Death due to the severe cerebral damage occurred 5 hours after the incident. An autopsy demonstrated a severe subcutaneous traumatization of the left side of the neck, with a hemorrhage compressing the carotid bifurcation. A prolonged excitation due to this ongoing compression of the baroreceptors in the carotid sinus was assumed to have led to a cardiac arrest. In this case report, the authors discuss the underlying pathophysiology of this potentially lethal and rare reflexogenic incident also known as the Hering reflex and discuss possible therapeutic measures.

Autopsy↗

PubMed2004

Retrograde blood aspiration: a vital reaction.

Blood aspiration, which is based on an intact breathing activity, is one of the forensically most important vital reactions. On the example of 11 forensic cases it is shown that the aspiration of blood into the lung tissue is possible not only when the bleeding source is situated above the trachea or main bronchi, but also in a retrograde way, taking its origin from an injury of the peripheral lung tissue itself. Equally to 'classical' blood aspiration, the findings of retrograde blood aspiration are to be diagnosed by means of macroscopical and histological examination of the lung tissue. The lung tissue presents with roundish, reddish spots, which are situated close to, but separate from a lung contusion or other lung tissue injury, and microscopical examination reveals blood in the alveoli and the bronchioli. Retrograde blood aspiration may be a helpful vital sign in the forensic assessment of thorax trauma cases where no other vital reactions are present.

Adolescent↗

PubMed2004

External injuries to the neck after free fall from great height.

Falls from great height are suicidal in most cases. Any antecedent trauma that would indicate an involvement of a third party should, however, be excluded in each case. Herein lies the difficulty in such cases since injuries prior to the fall which could be of criminal nature may be masked by the impact injuries. Injuries on unexposed parts of the body should always raise the suspicion of an involvement of a third party. This applies especially for neck injuries. By a retrospective analysis of 132 cases of falls from great height, the authors conclude, however, that neck injuries may occur after free fall from great height on a flat surface without antecedent trauma.

Accidental Falls↗

PubMed2003

Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)--a feasibility study.

Using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), 40 forensic cases were examined and findings were verified by subsequent autopsy. Results were classified as follows: (I) cause of death, (II) relevant traumatological and pathological findings, (III) vital reactions, (IV) reconstruction of injuries, (V) visualization. In these 40 forensic cases, 47 partly combined causes of death were diagnosed at autopsy, 26 (55%) causes of death were found independently using only radiological image data. Radiology was superior to autopsy in revealing certain cases of cranial, skeletal, or tissue trauma. Some forensic vital reactions were diagnosed equally well or better using MSCT/MRI. Radiological imaging techniques are particularly beneficial for reconstruction and visualization of forensic cases, including the opportunity to use the data for expert witness reports, teaching, quality control, and telemedical consultation. These preliminary results, based on the concept of "virtopsy," are promising enough to introduce and evaluate these radiological techniques in forensic medicine.

Adolescent↗

PubMed2003

Virtopsy-postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in a fatal scuba diving incident.

The body of a 44-year-old scuba diver was examined using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), and findings were verified by subsequent autopsy. The goal was to find out whether the important pathomorphological findings for the reconstruction of events and the identification of cause and manner of death could be identified using modem digital cross-sectioning techniques. The findings of a massive vital decompression with pulmonary barotrauma and lethal gas embolism were identified in the radiological images. MSCT and MRI were superior to autopsy in the demonstration of the extent and distribution of gas accumulation in intraparenchymal blood vessels of internal organs as well as in areas of the body inaccessible by standard autopsy.

Abdomen↗

PubMed2002

The response of relatives to medicolegal investigations and forensic autopsy.

Relatives of deceased persons, on whose body a forensic autopsy had been performed at the Institute of Forensic Science, Bern, Switzerland, were interrogated by a questionnaire. The aim was to investigate the attitude of relatives toward medicolegal investigation procedures in general and toward forensic autopsy in particular. A great majority of the relatives showed a positive or indifferent attitude toward a forensic autopsy. They showed a great interest in autopsy results and wished to be informed. It was concluded that information given before the autopsy is important for better understanding and can, if properly given, improve the relatives' acceptance and collaboration regarding forensic investigations. By contrast, a lack of information before the autopsy and about the autopsy results can cause further suffering on behalf of the bereaved. A forensic autopsy can be of great benefit for relatives and can help them to cope with a tragic loss.

Adult↗

PubMed2002

Charred body: virtual autopsy with multi-slice computed tomography and magnetic resonance imaging.

The correct examination of a charred body is a forensic challenge. Examination, interpretation, and conclusion in respect to identification, vital reactions, toxicological analysis, and determining cause and manner of death are all more difficult than without burns. To evaluate what can be seen in the case of a charred body, we made an examination with the new radiological modalities of cross-section techniques, via multi-slice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI), prior to performing the classical forensic autopsy. In a charred body case of a single motor vehicle/fixed object collision with a post crash fire, the radiological methods of MSCT and MRI made it possible to document the injuries caused by burn as well as the forensic relevant vital reactions (air embolism and blood aspiration). In conclusion, we think postmortem imaging is a good forensic visualization tool with a great potential for the forensic documentation and examination of charred bodies.

Autopsy↗