Unusual intracranial stab wounds inflicted with metal tent stakes for a case involving a family murder suicide.

This article presents a highly unusual homicide involving intracranial stab wounds. Of three members of a family killed by intracranial stab wounds apparently inflicted with metal tent stakes, two also showed signs of wounds inflicted during an apparent struggle with the assailant. A wooden mallet appears to be the implement use to drive the metal stakes into the cranial cavity. In all victims, toxicological analysis indicated the presence of brotizolam at concentrations ranging from 30 to 50ngml(-1). The one victim who showed no signs of wounds incurred during a defensive struggle was found to have blood alcohol levels of 2.87mgml(-1). The assailant, another family member with a history of major psychiatric disorders, apparently committed suicide by drowning following the attacks.