title: Suicide by head explosion: unusual blast wave injuries to the cardiovascular system.
abstract: A 57-year-old employee in a military scientific institute was found acephalous in a supine position in an anteroom to the bunker. On the walls was abundant spattering of blood and tissue, concentrated above shoulder height. A mobile ignition device stood on the control desk. The complete destruction of the head down to the cervical spine suggested that the explosive charge (RDX) detonated in his mouth. The hands were virtually uninjured. The pressure effect in vessels caused numerous tears to the wall of the carotid arteries and the left vertebral artery, a tear-off of the left carotid artery of the aortic arch, and a 2.5-cm long crack of the thoracic aorta with 540-ml blood in the pericardial sac and a shredded window-like disruption of the left aortic valve cusp. The autopsy also showed an infraction of the sternum from the inside, and a contusion of the superior lobes of both lungs. The trace pattern on the right arm suggested suicide. A bone fragment of the mandible penetrated the right biceps muscle as a secondary projectile.
authors.affiliation: Institute of Forensic Medicine, University of Bonn, Bonn, Germany. Christian.Schyma@ukb.uni-bonn.de
authors.forename: Christian
authors.initials: C
authors.lastname: Schyma
authors.forename: Lars
authors.initials: L
authors.lastname: Hagemeier
authors.forename: Burkhard
authors.initials: B
authors.lastname: Madea
mesh_terms: D001013:Aorta, Thoracic / Q000293:injuries / Q000473:pathology; D001021:Aortic Valve / Q000293:injuries / Q000473:pathology; D001134:Arm Injuries / Q000473:pathology; D001753:Blast Injuries / Q000473:pathology*; D002319:Cardiovascular System / Q000293:injuries* / Q000473:pathology; D020212:Carotid Artery Injuries / Q000473:pathology; D003288:Contusions / Q000473:pathology; D006259:Craniocerebral Trauma / Q000473:pathology*; D049248:Decapitation / Q000473:pathology*; D005107:Explosions / Q000331:legislation & jurisprudence*; D005858:Germany; D006335:Heart Injuries / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D055370:Lung Injury / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D018482:Muscle, Skeletal / Q000293:injuries / Q000473:pathology; D010496:Pericardium / Q000293:injuries / Q000473:pathology; D013405:Suicide / Q000331:legislation & jurisprudence*; D014711:Vertebral Artery / Q000293:injuries / Q000473:pathology
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