This middle-aged male individual was located in a burnt-out car with a knife protruding from his neck. This report only came with the medical info but not anything about the crime. The cause of death was from hemorrhage and inhalation of blood in the setting of a stab wound to the neck. The knife measured 32 cm (12.6″) in length: the blade was 20 cm (7.87″) long and the blade was 5 cm (1.96″) wide at the hilt (Fig.3).
Fig.1 Anterior view of the heavily burnt head and neck showing the knife (red arrows) in situ which entered the right side of the neck and exited beneath the left side of the chin.
There was a large wound present around the posterior and right side of the neck. It gaped up to 7cm (2.75″) in width, and embedded within it anteriorly was a wide-bladed knife (Figs.1-2). Because of the effects of the subsequent fire, only the metal parts of the knife remained. The path of the blade of the knife included the right side of the cervical spine between the transverse processes, but no bony defect was present.
Fig.2 Right lateral view of the head and neck showing the knife in situ and the associated large wound.
The path of the wound involved the major blood vessels in the right side of the neck (carotid arteries and jugular veins). In addition, the wound track divided the right wing of the thyroid cartilage entering the upper trachea, also damaging the posterior thyroid cartilage. In addition, there was a 5 cm (1.96″) defect in the lateral right pharyngeal wall. The wound track continued to the left side of the neck and exited 10 cm (3.93″) above the sternal notch in the left submandibular region.
Fig.3 Sagittal section of the cervical spine showing cord damage. The knife removed from the deceased demonstrating the portion protected from fire because of its location in the body.
The cervical spine was dissected and revealed a partial division of the spinal cord adjacent to the body of the 4th cervical vertebrae (Fig.3). There was a mild to moderate degree of hemorrhage associated with this, and hemorrhage was associated with the adjacent divided posterior skeletal structures.
Fig.4 VR images of the six standard views of the skull showing the metal blade of the knife inserting through the neck just inferior to the mandible.
A stab wound is a specific form of penetrating trauma in which the depth of penetration is greater than the length of the external wound. There was no soot seen in the individual’s airways, and there was no detectable carbon monoxide in the blood, that is, there was no evidence to suggest the individual was alive during the fire. There was a marked amount of blood entering the trachea and bronchi and marked retropharyngeal hemorrhage. Blood was present in the esophagus, and the stomach contained 200 mL of blood-stained fluid. These features indicated that the stab injury to the neck most probably occurred when the individual was alive. Although the sharp-force injury resulted in extensive soft tissue damage, no skeletal structures were affected (Figs.4-5).
Fig.5 Coronal reconstruction of the head and neck showing the blade of the knife between the 3rd and 4th cervical vertebrae but with no damage to the skeleton.
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