title: An unusual homicidal stab wound of the cervical spinal cord: A single case examined by post-mortem computed tomography angiography (PMCTA).
abstract: We report an unusual case of homicidal stab wound of the cervical spinal cord, which illustrates the value of post-mortem computed tomography angiography (PMCTA) in cases of vascular injury. First, we noted a posterior and horizontal trajectory to the neck with complete section of the cervical spinal cord between the first and second cervical vertebrae. This lesion was accompanied by section of the right vertebral and right deep cervical arteries. We also noted an anterior cervical trajectory with an injury to the right internal jugular vein and an anterior right chest wound with a lung trajectory and section of the internal mammary vessels. Cases of spinal cord injuries secondary to stab wounds are rare in the literature. Only one large series has been published from Cape Town. Complete section of the cervical spinal cord accounts for only 4.5% of all cases. Furthermore, lethal cases are rare and classically victims survive and present neurological sequelae. We found only one similar case but despite the transection of the cervical spinal cord the patient survived. Some studies suggest that PMCTA may be very helpful in visualizing vascular system injuries. Our observations are consistent with this proposal. The use of different-time acquisitions was essential for detection of the injured vessels.
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France. Electronic address: savall.f@chu-toulouse.fr.
authors.forename: Frederic
authors.initials: F
authors.lastname: Savall
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France; Service de Radiologie, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Dedouit
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France.
authors.forename: Fatima-Zohra
authors.initials: FZ
authors.lastname: Mokrane
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rougé
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Trousseau, Avenue de la République, 37170 Chambray-lès-Tours, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Saint-Martin
authors.affiliation: Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31403 Toulouse Cedex 4, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Telmon
mesh_terms: D000328:Adult; D000792:Angiography; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006708:Homicide; D006801:Humans; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000473:pathology; D014951:Wounds, Stab / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Autopsy; Cervical stab wound; Post-mortem computed tomography angiography (PMCTA); Spinal cord injury