REFLEX MECHANISMS OF DEATH IN MISSILE INJURIES OF THE NECK

Three cases of missile injury to the neck are reported, two homicides and one suicide. In two fatalities, the autopsy revealed contusion of the spinal cord due to direct missile injury of the cervical spine but without laceration of the spinal dura. It was concluded that the temp orary cavity following penetration of the bullet caused contusion of t he spinal cord with subsequent reflex cardiac arrest. In the suicide c ase, the entrance wound was in the mouth, the bullet track traversed t he pharynx and the cervical spine with complete transection of the cor d, and the bullet lodged in the right scalenus muscle. The lack of vit al signs such as blood aspiration, which was expected because of the i njury of the pharynx, also indicates immediate occurrence of death owi ng to a reflex mechanism in this case. The underlying reflex mechanism s are discussed in the light of clinical experience in the treatment o f paraplegics as well as the findings in experimental contusion and tr ansection of the cervical cord.