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Walk and Die: An Unusual Presentation of Head Injury

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We report three deaths in young adult males following closed blunt trauma to the head and face where the affected individuals were able to walk away from the incident, before subsequently collapsing and dying a short distance from the site of the assault. In each case, due to the rapidity of the posttrauma collapse, the pathologist was faced with a diagnostic difficulty at autopsy; the external examination revealed multiple injuries to the head and face, but internal examinations showed limited findings with no structural explanation for the death. We discuss possible mechanisms that could account for this scenario, the implications of alcohol consumption with a concussive head injury, and parallels that can be drawn with the so-called “talk and die,”“talk and deteriorate,” and “second impact syndrome.” Finally, the possible role of so-called “postexercise peril” is discussed in relation to these deaths.
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Keywords: forensic science; head injury; postexercise peril; posttraumatic apnea; second impact syndrome; talk and deteriorate; walk and die

Document Type: Research Article

Affiliations: 1: Stroke Rehabilitation, St Luke’s Hospital, Bradford, West Yorkshire, UK. 2: Dyke Farm, Greenholme, Penrith, Cumbria, CA10 3TA, UK. 3: East Midlands Forensic Pathology Unit, University of Leicester, Robert Kilpatrick Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK.

Publication date: November 1, 2009

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