In the discrimination of falls from blows in blunt head trauma, the hat brim line rule is one of the most often used criteria. The present study assesses the validity of the hat brim line rule for skull fractures and looks at other possible criteria. All autopsy cases were retrospectively analyzed on a 5‐year period. Cases selected consisted of downstairs falls (n = 13), falls from one’s own height (n = 23), and homicidal blows (n = 44). Results show that fractures above the hat brim line are more in favor of blows, while fractures in the hat brim line zone are more difficult to distinguish. The majority of fractures were located on the left side for homicidal blows and on the right side for falls. A higher average number of lacerations was revealed for homicidal blows. In conclusion, this study establishes three criteria in favor of blows: (i) localization of a wound above the hat brim line; (ii) left side lateralization; and (iii) a high number of lacerations.
The discrimination of falls from homicidal blows in blunt head injuries is a common but difficult problem in both forensic anthropology and pathology. Three criteria have been previously proposed for this distinction: the hat brim line rule, side lateralization of fractures, and number of lacerations. The aim of the present study was to achieve a better distinction rate by combining those criteria and assess the predictability of these combined criteria tools. Over a 6-year period, a total of 114 cases (92 males and 22 females) were studied: 21 cases of downstairs falls, 29 cases of falls from one's own height, and 64 cases of head trauma by a blunt weapon. The results revealed predictability rates varying from 62.5 to 83.3% for criteria pointing towards a fall. As for combined criteria in favor of a blow, the assumption was accurate in all cases (100%).
In the discrimination of falls versus blows, the hat brim line (HBL) rule is mentioned in several textbooks as the most useful single criterion. Recent studies, however, have found that the HBL rule is only moderately valid and that its use on its own is not recommended. The purpose of this 6-year retrospective study was to find additional individually useful criteria in the distinction of falls from blows. Overall, the following criteria were found to point toward blows: more than three lacerations, laceration length of 7 cm or more, comminuted or depressed calvarial fractures, lacerations or fractures located above the HBL, left-side lateralization of lacerations or fractures, more than four facial contusions or lacerations, presence of ear lacerations, presence of facial fractures, and presence of postcranial osseous and/or visceral trauma. Based on the most discriminating criteria, a decision tree was constructed to be potentially applicable to future cases.
In sharp force injury cases, the presence of hesitation marks or defense wounds figures among useful characteristics in the distinction of suicide and homicide. However, there are very few systematic comparative studies of hesitation marks and defense wounds in the forensic literature. This study was thus undertaken to systematically compare features of hesitation marks and defense wounds, with a particular emphasis on dispersion patterns. Over a 5-year period, all suicidal and homicidal sharp force cases were retrospectively reviewed for hesitation marks and defense wounds. A total of 58 suicides (7 women; 51 men) and 149 homicides (59 women; 60 men) were found, of which 74% (n = 43) were positive for hesitation marks and 61% (n = 91) for defense wounds. On the upper limbs, hesitations marks were more often observed on the anterior aspect of the limb, while defense wounds were equally distributed on the anterior and posterior aspect. For hand lesions, hesitation marks were generally located on one side only, while defense wounds more commonly involved both sides. No left or right predominance was observed in hesitations marks or defense wounds. Defense wounds were more widely distributed on the upper limbs than hesitation marks.
Exhumations cases have been the focus of very few retrospective studies. In fact, no study ever described unlawful burials, while exhumations of legally interred bodies were only described by German studies. In the present study, exhumation cases of legally interred and unlawful burials performed over a six-year period (2000-2005) in the province of Quebec, Canada, were retrospectively analyzed. A total of 8 cases were found, representing 0.2% of all forensic autopsies and 0,0024% of all deaths. Of those, 5 were unlawful burials (62.5%), whereas the remaining 3 (37.5%) were legally interred bodies. Overall, the time of interment ranged from 2 weeks to 2 years. Forensic pathologists participated in 5 of the 8 (62.5%) exhumation cases. Exhumations rates in different populations are discussed, as well as reasons to conduct an exhumation and if the forensic pathologist must be present on the scene.
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