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Shaken adult syndrome due to ocean wave: an autopsy case

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Abstract

Severe intracranial trauma during torture or assault is reportedly caused by shaken adult syndrome. However, intracranial traumas caused by natural forces, excluding human factors and collision impact, are extremely rare. We report an autopsy case of shaken adult syndrome caused by ocean wave forces. A man in his 40s without any medical history was washed away by a wave during recreational fishing. He was found approximately 500 m away from the fishing point drifting on the ocean in a state of cardiopulmonary arrest and was confirmed dead, with no response to cardiopulmonary resuscitation, 3 h after the accident. The autopsy revealed no mechanical trauma to the entire body surface, including the head. Both lungs were inflated, and pleural effusion was observed. The brain was swollen and congested, and subarachnoid hemorrhage was observed in the interhemispheric fissure and the convexity of the parietal occipital lobe. Macroscopic and microscopic hemorrhage spots were found in the brain, and the results of the blood alcohol test and urinary toxicological screening were negative. The cause of death was determined as drowning. This case demonstrates a rare but notable mechanism of injury observed in immersed bodies.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Moreno A, Grodin MA. Torture and its neurological sequelae. Spinal Cord. 2002;40:213–23. https://doi.org/10.1038/sj.sc.3101284.

    Article  CAS  PubMed  Google Scholar 

  2. Pounder DJ. Shaken adult syndrome. Am J Forensic Med Pathol. 1997;18:321–4. https://doi.org/10.1097/00000433-199712000-00001.

    Article  CAS  PubMed  Google Scholar 

  3. Azari AA, Kanavi MR, Saipe NB, Potter HD, Albert DM, Stier MA. Shaken adult syndrome: report of 2 cases. JAMA Ophthalmol. 2013;131:1468–70. https://doi.org/10.1001/jamaophthalmol.2013.5073.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Carrigan TD, Walker E, Barnes S. Domestic violence: the shaken adult syndrome. J Accid Emerg Med. 2000;17:138–9. https://doi.org/10.1136/emj.17.2.138.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gieron MA, Korthals JK, Riggs CD. Diffuse axonal injury without direct head trauma and with delayed onset of coma. Pediatr Neurol. 1998;19:382–4. https://doi.org/10.1016/s0887-8994(98)00072-1.

    Article  CAS  PubMed  Google Scholar 

  6. Bruggeman GF, Haitsma IK, Dirven CMF, Volovici V. Traumatic axonal injury (TAI): definitions, pathophysiology and imaging-a narrative review. Acta Neurochir (Wien). 2021;163:31–44. https://doi.org/10.1007/s00701-020-04594-1.

    Article  PubMed  Google Scholar 

  7. Mata-Mbemba D, Mugikura S, Nakagawa A, Murata T, Ishii K, Kushimoto S, Tominaga T, Takahashi S, Takase K. Traumatic midline subarachnoid hemorrhage on initial computed tomography as a marker of severe diffuse axonal injury. J Neurosurg. 2018;129:1317–24. https://doi.org/10.3171/2017.6.JNS17466.

    Article  PubMed  Google Scholar 

  8. Griepp DW, De la Garza Ramos R, Lee J, Miller A, Prasad M, Gelfand Y, Cardozo-Stolberg S, Murthy SG. Beach breaking waves and related cervical spine injuries: a level one trauma center experience and systematic review. World Neurosurg. 2022;160:e471–480. https://doi.org/10.1016/j.wneu.2022.01.055.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Masaki Teruya and Hideki Kinjo (Japan Coast Guard, 11th Regional Coast Guard Headquarters) for their help with scene reconstruction. We would also like to thank Takana Motoyoshi (K. I. Stainer Inc., Kumamoto, Japan) for providing excellent sections for immunohistological analyses. We would also like to thank Miltos Beratlis for the English editing.

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Authors and Affiliations

  1. Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Kenji Ninomiya, Natsuki Ikematsu, Hanae Nagama, Kazumichi Kakazu & Maki Fukasawa

  2. Department of Civil Engineering and Architecture, Graduate School of Engineering and Science, University of the Ryukyus, Okinawa, Japan

    Eizo Nakaza

  3. Department of Radiology, Yokohama City University, Kanagawa, Japan

    Tsuneo Yamashiro

  4. Department of Surgery, Chubu Tokusyukai Hospital, Okinawa, Japan

    Takayuki Abe

Authors
  1. Kenji Ninomiya
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  2. Eizo Nakaza
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  3. Tsuneo Yamashiro
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  4. Takayuki Abe
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  5. Natsuki Ikematsu
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  6. Hanae Nagama
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  7. Kazumichi Kakazu
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  8. Maki Fukasawa
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Contributions

Conceptualization: Kenji Ninomiya; numerical simulation: Eizo Nakaza; writing—original draft preparation: Kenji Ninomiya; writing—review and editing: Eizo Nakaza, Tsuneo Yamashiro, Takayuki Abe, Natsuki Ikematsu, Hanae Nagama, Kazumichi Kakazu, Maki Fukasawa.

Corresponding author

Correspondence to Kenji Ninomiya.

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We did not receive any written informed consents. Since we have carefully eliminated sensitive information of the deceased from this paper, we think that written informed consent is not required according to the journal’s guideline.

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We did not receive any written informed consents. Since we have carefully eliminated sensitive information of the deceased from this paper, we think that written informed consent is not required.

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The authors declare no competing interests.

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Ninomiya, K., Nakaza, E., Yamashiro, T. et al. Shaken adult syndrome due to ocean wave: an autopsy case. Forensic Sci Med Pathol 20, 233–238 (2024). https://doi.org/10.1007/s12024-023-00699-y

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  • DOI: https://doi.org/10.1007/s12024-023-00699-y

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