Medico-legal analysis of the correlation between head trauma and aneurysm rupture: A case report

We present the case of a 54 years old man who was found in a state of confusion and a forehead wound. Transported to the closest E.R., a brain CT scan showed massive subarachnoid hemorrhage and an angiographic exam showed a ruptured aneurysm of the cavernous siphon. Death occurred 4 days after admission. The autopsy showed the presence of a linear wound on the forehead which was considered a sharp force injury. The aneurysm rupture was therefore considered as a consequence of the head trauma associated to the frontal wound. In the medico-legal analysis of the case primary importance was given to the distinction between potential homicide, suicide or accident. In the end, based on the morphological features of the forehead wound, this case was defined as of potentially homicidal nature, so that the responsible of stab wound should be considered accountable for the man’s death. • Causal relation between head trauma and aneurysm rupture is poorly correlated. • Medico-legal issues arise in the distinction between natural death, homicide and suicide. • The analysis of such cases needs integration of a full autopsy and thorough analysis of circumstantial evidence. • This paper is a call to the scientific community to study epidemiological and medico-legal aspects of the issue.