Autopsy Case of a Penetrating Wound to the Left Cerebral Hemisphere Caused by an Accidental Shooting With a Crossbow

Abstract

A crossbow is a bow that shoots an arrow when a gun-like trigger is pulled. Deaths caused by accidental crossbow shootings are extremely rare. Here we describe an autopsy case of a penetrating wound to the left cerebral hemisphere caused by an accidental shooting with a crossbow. A man in his early 60s who lived with his wife and had used crossbows for 20 years as his hobby was found one early morning in the shed of his house, collapsed and bleeding from the head and neck. He was taken to a hospital and died after approximately 3 days of conservative treatment. At autopsy, a penetrating wound between the upper part of the left anterior neck and the left frontoparietal region was evident. Traumatic intracerebral hematoma was observed in the left frontal lobe, and severe traumatic subarachnoid hemorrhage was present throughout the brain. Cerebral contusion and hematoma without any organization were noted around the penetration. The cause of death was determined to be cerebral contusion and intracerebral hematoma due to the penetrating wound by the crossbow arrow. He was probably trying to load an arrow into the crossbow by placing it on the floor, pointing upward, and made a mistake in its operation that resulted in the shooting of the arrow. This case is unique because it was a rare accidental death caused by a crossbow arrow, and a detailed histopathological examination was performed.

Crossbow Bolt Penetrating the Neck Removed with the Assistance of an Endovascular Approach: A Case Report and Literature Review

“…Previous reports have indicated that there is no difference in the pathological characteristics of injuries caused by suicide, accident, and homicide. 6) The overall survival rate was 80% (4/5 cases) according to the previous reports. 3,[5][6][7] Regarding the reason for death, it was considered to be caused by the site of injury rather than differences in the mechanism of injury (e.g., the main cause of death was brain injury in Kondo's report).…”

“… 3 , 5 - 7 ) Regarding the reason for death, it was considered to be caused by the site of injury rather than differences in the mechanism of injury (e.g., the main cause of death was brain injury in Kondo's report). 6 ) Among them, a case of removal of a crossbow bolt under fluoroscopy with the assistance of an endovascular approach has not been reported. In 75% of these cases, the blood vessels were in contact with a crossbow bolt.…”

“…Many cases of penetrating neck injury by a foreign body such as gunshot have been reported, 1,[9][10][11][12] but there were only four cases of penetrating neck injury by a crossbow bolt in the literature (Table 1). 3,[5][6][7] The neck injury in the present case was caused by an attempt to homicide. In these previous NMC Case Report Journal Vol.…”

“…1,2) However, penetrating head and neck injuries by a crossbow bolt are very rare in developed countries. [3][4][5][6][7] Penetrating neck injuries by a crossbow bolt can be lifethreatening because the bolt can injure crucial vessels, such as the carotid or vertebral arteries and jugular veins. 3,[5][6][7] Furthermore, this injury may involve the trachea, larynx, pharynx, esophagus, hypoglossal and vagal nerves, or the spinal cord.…”

“…[3][4][5][6][7] Penetrating neck injuries by a crossbow bolt can be lifethreatening because the bolt can injure crucial vessels, such as the carotid or vertebral arteries and jugular veins. 3,[5][6][7] Furthermore, this injury may involve the trachea, larynx, pharynx, esophagus, hypoglossal and vagal nerves, or the spinal cord. 8) Hence, the strategy for removing a crossbow bolt should be considered seriously according to the insertion course of the crossbow bolt and the damaged organs.…”