Sidlo Jozef, Sidlova Henrieta
Institute of Forensic Medicine, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
Institute of Pathology, Faculty of Medicine, Slovak Medical University and Cytopathos Ltd., Limbova 12, 833 03 Bratislava, Slovakia.
Forensic Sci Int. 2018 Dec;293:e1-e4. doi: 10.1016/j.forsciint.2018.10.014. Epub 2018 Oct 28.
A case of long-term continual self-inflicted penetrating craniocerebral injury to a 59-year-old man with a fatal outcome is reported. The man suffered from paranoid psychosis and alcohol dependence. Over five months, he continually scalped the skin and subcutaneous tissue of his head with a knife until he perforated the skull and dura mater and injured his brain. He eventually sought medical advice, but died after 10 days of hospitalization despite complex conservative treatment. The immediate cause of death was a combination of central nervous system failure and heart failure. The original case presented is sporadic in the forensic literature due to atypical long-term continual self-harm to the head and brain using a sharp object that resulted in perforation of the skull and a fatal outcome. This case also highlights the importance of autopsy to determine the mechanism of injury and cause of death.
报告了一例59岁男性长期持续自我造成的穿透性颅脑损伤并导致死亡的病例。该男子患有偏执型精神病和酒精依赖症。在五个多月的时间里，他不断用刀割头皮和皮下组织，直至穿透颅骨和硬脑膜并损伤大脑。他最终寻求医疗帮助，但尽管接受了复杂的保守治疗，仍在住院10天后死亡。直接死因是中枢神经系统衰竭和心力衰竭。由于使用锐器对头部和大脑进行非典型的长期持续自我伤害导致颅骨穿孔并造成致命后果，该原始病例在法医文献中较为罕见。此病例还凸显了尸检对于确定损伤机制和死因的重要性。
