Nail injury to the brain obfuscated by a fall from height – homicide or suicide? A case report

Abstract

Penetrating head injuries caused by unconventional objects such as a nail generate speculation and doubt regarding the manner of infliction. We report a case of a 24-year-old woman alleged to have committed suicide by a fall from height. Autopsy revealed an unprecedented penetrating intracranial injury caused by a nail over the right temporal region, confounding the manner of death. The underlying intersecting pattern of fractures determined the chronological sequence of events. In this paper, we discuss the manner, incidence and pathology of nail injuries to the brain.

Homicides Disguised as Staged Suicides

“…Zietlow and Hawley report three separate intraoral gunshot associated deaths thought initially to be suicides which were ultimately determined to be homicides (17). In another report, a woman was found to have apparently jumped from the third floor of her house; although initially thought to be a suicide, it was determined that the decedent suffered a homicidal head/skull injury prior to the fall (18). This is a good example of how a homicide may be committed and then the perpetrators may try to cover-up the underlying injuries by attempting to give the appearance of a suicide, such as jumping off a building.…”

An Anthropological Examination of the Types of Skeletal Fractures Resulting from Fatal High (˃3 m) Free Falls,

“…Thus, detailed scientific investigations that specifically focus on the types of fractures that result from high falls have not been considered in the literature to date. Rather, detailed and contextualized documentations of fracture types resulting from fatal high free falls have only been reported in anecdotal forensic anthropology and forensic pathology case reports. These cases use fracture types to address complex trauma questions pertaining to the interpretation of the BFT mechanism as a high fall in order to augment the circumstances of the individual's death.…”