[hermantheshocker]

A 60-year-old male was fatally injured as a pedestrian when a loader ran over him, injuring his head and trunk. The head was deformed due to side-to-side compres- sion (Fig. 1) and brain tissue was evident in the right external auditory canal (Fig. 2). Multiple head fractures were present, including the fracture of the petrous part of the temporal bones (hinge fracture) with dura and brain lacerations. Detached brain tissue was found in the trachea (windpipe) (Fig. 3). The victim also sustained multiple inner organ injuries and bone fractures.


Fig.1 Deformed head with multiple abrasions and lacerations, indicates side-to-side compression.

Bleeding from the ears, nose, or mouth following a closed-head injury suggests a fracture of the base of the skull. Brain tissue could be expelled through these apertures, even in the absence of external evidence of an injury. The presence of brain tissue in the external auditory canal is a relatively uncommon phenomenon, but one that could be expected in side-to-side head compression. In those cases, the force applied to the head is considerable, resulting in excessive pressure and kinetic energy being transferred to the brain tissue. One of the mechanisms of the hinge fracture is also side-to-side head compression.


Fig.2 Brain tissue in the right external auditory canal. The ear lobe is heavily bruised.

Many basilar skull fractures originate from impacts at the roughly same level as the skull base and the fracture lines follow predictable routes through the skull base. A hinge fracture refers to a fracture that runs from side to side, across the floor of the middle cranial fossa, passing through the pituitary fossa in the midline. This injury is common in road accidents and is sometimes called the “motorcyclist’s fracture”.

From the site of applied force, which is usually bitemporal (latero-lateral), fracture lines lead to the separation of the petrous part of the temporal bone from the greater wing of the sphenoid and the squamous temporal bone, splitting the base of the skull into two. Any considerable pressure applied to the head pushes brain tissue equally in all directions, due to its incompressibility.


Fig.3 Detached brain tissue in the superior part of the trachea (windpipe).

Brain tissue then passes through the lacerated dura into the fractured petrous part of the temporal bones, finally reaching the middle ear cavity. Since this must cause a rupture in the tympanic membrane, the blood and brain tissue ends up in the external auditory canal which is why they can easily be detected at external examination (as seen in this case).

The tissue follows the path of least resistance, thus being literally “thrust into the ears” as the result of the high pressure applied on the head. This could be easily demonstrated by using a simple autopsy technique, the so-called” water test “– water poured in an upwardly facing ear result in drainage from the nose and opposite ear, thus demonstrating transcranial passage. The mechanism of injury could be squeezing or compression of the head, either between two solid objects or as the result of being run over by a vehicle.

If the pressure to the head is considerable and the body of the sphenoid bone is crushed, the pieces of detached brain tissue can reach the nasopharynx, larynx, and even trachea. In these cases, the presence of brain tissue in the trachea should be considered a purely mechanical phenomenon (the tissue is forcefully pushed), which means that it was not a vital reaction, i.e. brain aspiration.

-

This post is for educational purposes only and is nonprofit. Under Section 107 of the US Copyright Act of 1976; Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. OP is not a medical expert. No copyright infringement intended. This post does not encourage or glorify violence/harassment. Images might have been upscaled and enhanced. Text might have been shortened and simplified/reorganized for online view.

[ride]

What. The. Fuck. Fig 1 - looks like my neighbor's two-day-old baby's photo. Not a looker, but then at that age they rarely are.

Exceptional work as always, Herman.

[Ferocity]

Thank you!

[CaptainPicard]

Sad. He was just trying to get ahead in life...

[William May]

Originally Posted by CaptainPicard ↗

Sad. He was just trying to get ahead in life...

The loader was trying to get a head, also. It looks like it succeeded!

[Vixənn]

noice!
that guy was an idiot.

thanks, herman.

[Brynjar]

Finally, we get to see Rosemary's baby!!?

[ChristySD]

Cabbage Patch Kid……

[Cathedral]

it's a delight to finally see a crushed old fuck who actually bothered to shave, and man, that's a close shave! i can smell old spice through my computer, plus no nose hairs! but he missed a few gray ones on his ear, so he's STILL a fuckin' slob and deserves a bruised knot on the head for his transgression (probably had intentions to fornicate on the sabbath day)