Tonkrugschläge gegen den Schädel

Background

The forensic biomechanical assessment of injuries resulting from blows with beer steins plays an important role in southern parts of Germany and in Austria, especially during the annual autumn festivals. In this context, forensic experts are often faced with the question of the injury potential of this special form of physical violence.

Objective

This article deals with the forensic and biomechanical aspects of head injuries caused by blows with a beer stein. The relationship between the type and severity of injuries as well as the intensity and execution form of blows were investigated.

Material and methods

In this study 30 brand new 0.5 l beer steins from 3 different breweries were analyzed in terms of potential risk of injuries when used as a blunt force weapon and the fragmentation behavior. The beer steins were manually wielded and used to hit a model dummy skull (aluminium core of a Hybrid III head form) with a silicon scalp, which was fixed onto a measuring plate. The contact force and speed of the stein were measured immediately before impact. The dynamics and fragmentation behavior were recorded with an Olympus i?Speed 3 high-speed digital camera with a Nikon AF Nikkor 50 mm f/1.8D lens and analyzed using the Olympus i?speed 3 viewer software.

Results

This series of experiments showed that the impact speed and the contact surface of beer steins have a significant influence on the fragmentation behavior, the energy transferred and thus on the injury potential.

Conclusion

The underlying principles of the fragmentation behavior of beer steins allow tentative conclusions to be drawn for reconstruction of the event leading to the fragmentation. Blows to the head of a person using a beer stein are fundamentally capable of inflicting life-threatening injuries. A forensic biomechanical assessment of injuries caused by beer steins should be carried out only after collating all information relating to the course of events. Comparative investigations can be necessary.

     

Schäden des Zentralnervensystems bei Drogenkonsum

Clinical issue

Illicit drugs can cause a myriad of CNS damages. The toxicity might be caused by the drug itself or by diverse contaminants. The most common changes are ischemic and hemorrhagic stroke as well as subarachnoid hemorrhage and leukoencephalopathies. This article gives a review of the most important morphological imaging findings of the CNS in illicit drug users.

Practical recommendations

In cases of stroke or unclear leukoencephalopathies in young adults, the differential diagnosis of illicit drug use should be considered.

     

Intubation und Sedierung bei der endovaskulären Therapie des akuten Hirninfarkts

In the past complex intracranial treatments demanded intubation and general anesthesia of the patient. With increasing rate of endovascular local treatment of acute stroke more and more neurointerventionalists report that recanalisation techniques can be performed in sedation of the patient without the need of additional intubation. Although prospective studies are lacking retrospective studies have shown that the risk of iatrogeneous vessel injuries without global anesthesia is not increased but outcomes in case of conscious sedations are better compared with intubation and general anesthesia.     

Anatomie und Fehlbildungen der hinteren Schädelgrube

Many important structures are located in the confined space within the posterior cranial fossa. This article describes the main aspects of the anatomy. As a uniform classification of malformations of the posterior cranial fossa does not exist the main syndromes, such as Chiari malformations, zerebellar hypoplasia and dysplasia are discussed separately.     

Ultraschalldiagnostik bei muskuloligamentären Verletzungen sowie Insertionstendinopathien am Ellenbogengelenk

Introduction

Acute capsular injuries of the elbow joint and its ligaments predominantly occur after joint dislocation or subluxation. Together with lateral and medial epicondylitis they represent a common injury pattern in radiology, orthopedic and trauma surgery.

Clinical issue

Because of the complexity of the elbow joint, knowledge of the elbow dislocation and injury pattern as well as the anatomy is essential in order to adequately estimate the injury severity and joint stability. This is crucial for the correct diagnosis and choice of treatment. Systematic physical examination and careful radiographic evaluation are components of an adequate management of acute soft tissue elbow injuries.

Diagnostic work-up

The cost-effective ultrasound has emerged as a useful imaging modality for the diagnosis of acute joint and soft tissue pathologies especially in the acute phase after injury. Ultrasound as a diagnostic tool enables visualization of motion sequences during dynamic examination and therefore a better understanding of pathologies. Ultrasound examinations of the most common injuries of the elbow joint are presented in this overview.

     

MRT des Sprunggelenks Vergleich eines Ganzkörper-Mittelfeldgeräts (1,0 T) mit einem dedizierten Niederfeldgerät (0,2 T)

PURPOSE: Comparison of ankle joint injuries with different MR systems and at different field strengths. METHOD: Ten patients with acute ankle injuries were examined using mid-field (1.0 T) and dedicated low-field (0.2 T) MR units. Findings of ligamentous injury, sinus tarsi involvement, bone injury, and tendon injury were correlated. RESULTS: There was no significant difference between mid- and low-field MR imaging for ligamentous injuries (chi 2 = 0.0395), sinus tarsi changes bone injuries (chi 2 = 0.0507; critical value = 5,991). CONCLUSION: This study showed good agreement in pathological findings in ankle injury on mid-field and low-field MR imaging.     

Der altersdiagnostische Sachverständigenbeweis nach § 42f SGB VIII

The challenge of “doubtful allegations of being a minor” in association with missing or unreliable documentation of identity occurs in legal procedures concerning “foreign persons”. Following the implementation many years ago of clear provisions for the “high requirements for fulfilling the official inquisitorial principle” for age identification within the Residence Act, the legislator recently regulated the “official procedure for age determination” for taking “suspected minors” into care within the legal context of the Social Code Book. Against the background of the European Union Procedures Directive, the Administrative Procedures Act and the judicature, the principles of the official inquiry into the circumstances are emphasized and possibly necessary medical expert evidence is defined. This article comments on aspects of the genesis of the new norm and certain passages of the legislative text also paying attention to the corresponding explanatory notes.     

Tod eines 79 Jahre alten Mannes mit einem linksventrikulären Herzunterstützungssystem

Cardiovascular illnesses are among the most common diseases in the western world and can lead to high-grade lesions of the myocardium. Consequently for example, in cases of refractory terminal heart failure, a heart transplant may be unavoidable as the last treatment option. Ventricular assist devices have been developed to improve the quality of life for patients waiting for a donor heart. Such devices are also used in patients unsuitable for a heart transplant and as a temporary support for cardiac function. Despite a correctly working ventricular assist device, the underlying disease can still lead to death. This article deals with a 79-year-old man who was found lifeless in the bathroom and who had worn a left ventricular cardiac support system for approximately 6 years. The ventricular assist device was found to be technically error-free, so that in the light of the assessment of the control data, clear overweight of the fibrous heart and severe coronary artery disease, acute (right) heart failure could be assumed to be the cause of death. Based on this case, the functioning of such a heart assist system is explained, the explantation is described and possible causes of death are discussed.     

Rechtsmedizinische Aspekte der Lichtenberg-Figuren nach Blitzschlag

After long debates about the pathomorphology of lightning-related Lichtenberg figures, the current understanding is that these erythema are independent of anatomical structures and temporary, except on the skin surface. Lichtenberg figures may occur after lightning or, in extremely rare cases, after a high-voltage accident in both living and deceased victims and are of diagnostic relevance. Since Lichtenberg figures have been observed on golf turf, a leather shoe, a wax figure, and a paving stone in lightning accidents, thorough inspection of the area around the accident site is important.