Dog bites or knife wounds? A case report of atypical neck injuries.

A 24-year-old woman was brought to the emergency department after suffering dog bites, as reported by a witness. Autopsy revealed 21 deep wounds of the neck, along with unclear injuries to both carotid arteries, extensive damage to neck muscles, a wound to the larynx, and the right lobe of the thyroid gland had been avulsed. The forensic pathologist initially concluded that the cause of death was asphyxia and haemorrhagic syndrome. Furthermore, due to the nature of some wounds resembling stab wounds, as well as facial injuries and marks consistent with gripping, the death was initially considered a possible homicide rather than attributing it to dog bites. Following these findings, the investigation took a drastic turn, resulting in the arrest of the witness. Three years later, our team was consulted for a second opinion. Reviewing the medical records confirmed dissection of both carotid and vertebral arteries without complete section, and fractures of cervical transverse processes, with the left and right vertebral arteries occluded by a bone fragment as seen on a CT scan from the emergency department. The second forensic expert supported the conclusion that the cervical injuries were consistent with dog bites, particularly due to the torn appearance of the muscle masses and soft tissue avulsion. Additionally, the vascular dissections and cervical fractures were attributed to hyperextension and/or compression of the neck, consistent with the dynamics of a dog attack involving shaking or grabbing the neck. Similar types of injuries have been documented in the scientific literature in cases of dog attacks. Furthermore, instances of wounds resembling stab wounds following dog bites have also been reported. The experts conclude that death was secondary to cerebral anoxia resulting from multiple dissections of neck vessels, aggravated by blood spoliation and asphyxia related to the laryngeal wound. All of the wounds were consistent with dog bites, leading to the release of the defendant.