Blunt Force Injury Deaths | Part # III

[gatagato]

See also:
http://www.documentingreality.com/fo...part-i-155547/
http://www.documentingreality.com/fo...art-ii-156217/



Fig. 12.67
As bruises may not be easily seen through hair,
the first indication of blunt head trauma at
autopsy may be bruising under the scalp
(subgaleal hematomas) after the scalp has been reflected


Fig. 12.68
An epidural hemorrhage. Note that the
collection of blood is outside the dura
(a portion of the dura on the left side
of the image is reflected, exposing the
underlying brain). Epidural hemorrhages
typically occur in association with a side-of-the
head impact with fracture of the temporal bone,
and laceration of the middle meningeal artery


Fig. 12.69
Visualization of the bridging vessels that connect the dura
(attached to the under surface of the skull)
to the meninges overlying the brain


Fig. 12.70
An acute subdural hemorrhage. The dura in this case has remained
adherent to the inner aspect of the skull


Fig. 12.71
A subdural hemorrhage visualized through
the relatively translucent dural membrane,
which has been left intact over the brain in
this dissection


Fig. 12.72
An acute subdural hematoma also visible
through the dura


Fig. 12.73
Comparison of a dark purple acute subdural
hematoma beneath the dura on the left side of the
head with normal dura on the right


Fig. 12.74
Removal of the dura reveals a thin film of subdural
hemorrhage in addition to subarachnoid
hemorrhage posteriorly


Fig. 12.75
Subdural hematomas may be composed of both clotted and fluid blood,
the latter which may drain away when the skull is opened


Fig. 12.76
A relatively dense subdural
hemorrhage. A flap of dura is being
reflected upward in order to
visualize the underlying subdural
blood


Fig. 12.77
A larger collection of recent blood
clot in an acute subdural
hematoma following a fall. This
was only revealed at autopsy once
the dura had been removed and
can be seen pushing the brain to
the right


Fig. 12.78
Left-sided basilar subdural hemorrhage after removal of the brain


Fig. 12.79
Formalin-fixed subdural hematoma and attached dura that can be submitted
for histologic dating


Fig. 12.80
Older subdural hematomas begin to organize and turn yellow as hemoglobin pigment
in red blood cells begins to break down


Fig. 12.81
A healing (or ‘‘organizing’’) subdural hemorrhage also showing yellow discoloration


Fig. 12.82
Another organizing subdural hematoma with green discoloration and ‘‘membrane’’ formation


Fig. 12.83
Extensive subarachnoid hemorrhage surrounding the brain


Fig. 12.84
The base of a brain with minimal subarachnoid hemorrhage over the temporal and frontal poles


Fig. 12.85
Focal left-sided subarachnoid hemorrhage overlying areas
with cerebral contusions


Fig. 12.86
Blunt head trauma may result in significant
swelling of the brain seen first as flattening
of gyri (folds) of the cortex when the skull
cap is removed


Fig. 12.87
Bruising of the brain may involve the
frontal poles if the head has been hit on the
front (coup lesions) or if the body has fallen
backward and landed on the posterior
aspect, the occiput (contra coup lesions)


Fig. 12.88
In vehicle accidents, there may be multifocal areas of bruising within the brain


Fig. 12.89
Close-up view of multiple cerebral cortical contusions in a formalin-fixed brain


Fig. 12.90
Deep contusions within the brain. Note the ‘‘midline shift’’ of central structures,
from right to left, due to the injury and associated
swelling (the brain is being viewed from behind)


Fig. 12.91
A gliding contusion of the cerebrum


Fig. 12.92
A brain with a cortical contusion (lower left) and associated brain swelling
with midline shift and a cingulate gyrus, subfalcine, herniation
(arrow)


Fig. 12.93
Bilateral temporal lobe uncal herniation with contusions


Fig. 12.94
An example of uncal ‘‘notching,’’ when the uncal regions are compressed
but not yet hemorrhagic (arrows)


Fig. 12.95
Cerebellar tonsillar herniation with contusion


Fig. 12.96
A transcalvarial herniation through a skull defect occurring in a head trauma victim who underwent craniotomy (removal of a portion
of the skull) surgery to relieve intracranial pressure. A relatively large area of swollen brain tissue has protruded outward (arrows)
from the remainder of the brain


Fig. 12.97
Duret hemorrhages within the midbrain of a person who sustained severe head trauma but survived for several hours


Fig. 12.98
Widespread, severe cerebral edema (brain swelling). The linear cut on the side of the brain occurred when the skull cap was being
removed at autopsy


Fig. 12.99
An immunohistochemical stain showing brown staining areas indicative of axonal injury


Fig. 12.100
A remote (old) contusion of the brain. Note the
depressed, brown-yellow appearance



References
Burke MP. Forensic medical investigation of motor vehicle incidents. Boca Raton:
CRC Press; 2007.
Byard RW, Bhatia K, Reilly P, Vink R. How rapidly does cerebral swelling follow
trauma? Observations using an animal model and possible implications in
infancy. Leg Med. 2009;11S1:S128–S131.
Byard RW, Gilbert J, James R, Lipsett J. Pathological features of farm and tractor –
related fatalities in children. Am J Forensic Med Pathol. 1999;20:73–77.
Byard RW, Tsokos M. Avulsion of the distal tibial shaft in aircraft crashes.
A pathological feature of extreme decelerative injury. Am J Forensic Med
Pathol. 2006;27:337–339.
Byard RW, Vink R. The second impact syndrome. Forensic Sci Med Pathol.
2009;1:36–38.
Byard RW, Wick R, Gilbert JD, Donald T. Histologic dating of bruises in moribund
infants and young children. Forensic Sci Med Pathol. 2008;4:187–192.
Dix J, Graham M, Hanzlick R. Investigation of road traffic fatalities – an atlas.
Boca Raton, FL: CRC Press; 2000.
Ehrlich E, Maxeiner H. External injury marks (wounds) on the head in different
types of blunt trauma in an autopsy series. Med Law. 2002;21:773–782.
Ingham AI, Langlois NEI, Byard RW. Bruises as a marker of other injuries at
autopsy. Arch Dis Child. 2011; 96:218–220.
Langlois NEI. The science behind the quest to determine the age of bruises –
a review of the English language literature. Forensic Sci Med Pathol.
2007;3:241–251.
Marshall DT, Gilbert JD, Byard RW. The spectrum of findings in cases of sudden
death due to blunt cardiac trauma – ‘commotio cordis. Am J Forensic Med
Pathol. 2008;29(1):1–4.
Murphy GK. Beaten to death. An autopsy series of homicidal blunt force injuries.
Am J Forensic Med Pathol. 1991;12:98–101.
Pearl GS. Traumatic neuropathology. Clin Lab Med. 1998;18:39–64.
Teresinski F, Madro R. Evidential value of injuries useful for reconstruction of the
pedestrian-vehicle location at the moment of collision. Forensic Sci Int.
2002;128:127–135.
Toro K, Szlavik N, Meszaros A, Dunay G, Soos M, Keller E. Jumping and falling
death in children, adolescents, and young adults. J Clin Forensic Med.
2006;13:129–134.
Turk EE, Tsokos M. Pathologic features of fatal falls from height. Am J Forensic
Med Pathol. 2004;25:194–199.
Turk E, Tsang Y-W, Champenari A, Pueschel K, Byard RW. Cardiac injuries in car
occupants in fatal motor vehicle collisions – an autopsy based study.
J Forensic Leg Med. 2010;17:339–343.
Zivot U, DiMaio VJ. Motor vehicle-pedestrian accidents in adults. Relationship
between impact speed, injuries, and distance thrown. Am J Forensic Med
Pathol. 1993;14:185–186.
Zugibe FT, Costello JT. Identification of the murder weapon by intricate patterned
injury measurements. J Forensic Sci. 1986;31:773–777.
486 12 Blunt Force Injury Deaths

Source:
The Atlas of Forensic Pathology for Police, Forensic Scientists, Attorneys and Death Investigators

[Lambiesinclair]

nice

[allison]

All those moments will be lost in time, like tears in rain... Time to die

[galaxia]

Just a little thought experiment:

I wonder if there would be any way to read/interpret memories from a 'dead' brain. At very least the last, traumatic moments of someones life which would provide evidence for witlessness violent crimes.

I say this because surely not all memories and experiences are instantly wiped once a person has died. There has to be a period after death where it is viable to read memories from a structurally intact brain. (the brain is itself intact, just lacking a living host to interpret and interface with it)

I just had the thought from looking at the slithers of brain in the pics, countless memories, thoughts, and experience once traveled through that sliver, I wonder if they are still there, frozen in time waiting to be read

[Sharon]

gatagato this thread is, as Dexter's sister Debra Morgan says, "fucking A!"

[wujuan]

my auntie just ordered this book for me. I love her.

[kellyhound]

mmmmm brains

[dockman]

Originally Posted by galaxia

Just a little thought experiment:

I wonder if there would be any way to read/interpret memories from a 'dead' brain. At very least the last, traumatic moments of someones life which would provide evidence for witlessness violent crimes.

I say this because surely not all memories and experiences are instantly wiped once a person has died. There has to be a period after death where it is viable to read memories from a structurally intact brain. (the brain is itself intact, just lacking a living host to interpret and interface with it)

I just had the thought from looking at the slithers of brain in the pics, countless memories, thoughts, and experience once traveled through that sliver, I wonder if they are still there, frozen in time waiting to be read

Interesting idea.

[Azimuth]

Originally Posted by galaxia

Just a little thought experiment:

I wonder if there would be any way to read/interpret memories from a 'dead' brain. At very least the last, traumatic moments of someones life which would provide evidence for witlessness violent crimes.

I say this because surely not all memories and experiences are instantly wiped once a person has died. There has to be a period after death where it is viable to read memories from a structurally intact brain. (the brain is itself intact, just lacking a living host to interpret and interface with it)

I just had the thought from looking at the slithers of brain in the pics, countless memories, thoughts, and experience once traveled through that sliver, I wonder if they are still there, frozen in time waiting to be read

That is a nice thought, but probably not. My reason for guessing no, is that when I had a Traumatic Brain Injury in October 2009, one of my doctors explained my lack of any memory whatsoever of the incident as this: at the moment the brain was interrupted or shut down (I was comatose), it was in the process of forming memories, (like they always do, constantly), and therefore the formation of memories also stopped.

Not only did I have no memory of the accident itself, but I still have some trouble with short term memory in general, and the whole year or so prior to the accident is very foggy, unless someone describes something in great detail, or I read of something that occurred within that time frame. Four and a half years later, I am probably 80% recovered mentally, and that has taken some work especially within the first two years, and I'm sure I am done recovering--but I'm very happy with that.

[galaxia]

Originally Posted by azimuth

That is a nice thought, but probably not. My reason for guessing no, is that when I had a Traumatic Brain Injury in October 2009, one of my doctors explained my lack of any memory whatsoever of the incident as this: at the moment the brain was interrupted or shut down (I was comatose), it was in the process of forming memories, (like they always do, constantly), and therefore the formation of memories also stopped.

Not only did I have no memory of the accident itself, but I still have some trouble with short term memory in general, and the whole year or so prior to the accident is very foggy, unless someone describes something in great detail, or I read of something that occurred within that time frame. Four and a half years later, I am probably 80% recovered mentally, and that has taken some work especially within the first two years, and I'm sure I am done recovering--but I'm very happy with that.

It's great to hear you have recovered :) Your comment reminds us of how fragile our brain is, and how much we rely on it to function correctly.

Which leads to the question of whether a) the memories are wiped/lost (any loss of life and memories deteriorate immediately and rapidly), or b) just the pathways to access the memories are damaged (they are still there in isolated parts of the brain, waiting to be read).

I need to google some studies on this. I'm sure it's been researched.