Abstract
A man wearing no protective helmet was struck by a motor vehicle while riding a bicycle. He was loaded on his left side, and the impact point of his head was his occiput on the car roof girder. He was immediately transported to the general hospital, where he passed away. Postmortem examination using multi-slice computed tomography (MSCT) revealed an extensively comminuted fracture of the posterior part and the base of the skull. Observed were deep direct and contrecoup brain bruises, with the independent fractures of the roof of the both orbits. Massive subdural and subarachnoidal hemorrhage with cerebral edema and shifting of the mid-line towards left side were also detected. MSCT and autopsy results were compared and the body injuries were correlated to vehicle damages. In conclusion, postmortem imaging is a good forensic visualization tool with great potential for documentation and examination of body injuries and pathology.
Issue Section:
Research Papers
References
1.
Sevitt
S
. Fatal road accidents. Injuries, complications, and causesofdeath in 250 subjects
. Br J Surg
0007-1323 1968
;55
(7
):481
–505
.2.
Freytag
E
. Autopsy findings in head injury from blunt forces
. Arch Pathol
0363-0153 1963
;75
:402
–13
.3.
Vance
BM
. Fractures of the skull—complications and causes of death: a review of 512 necropsies and of 61 cases studied clinically
. Arch Surg
0004-0010 1927
;14
:1023
–92
.4.
LeCount
ER
, Apfelbach
CW
. Pathologic anatomy of traumatic fractures of cranial bones—and concomitant brain injuries
. JAMA
0098-7484 1920
;74
:501
–11
.5.
Hooper
R
. Injuries of the skull
. In: Patterns of acute head injury
. Baltimore
: Williams and Wilkens
, 1969
:21
–30
.6.
Vondra
J
. Fractures of the base of the skull
. Springfield
: Charles C. Thomas
, 1965
.7.
Gurdjian
ES
. Impact head injury
. Springfield
: Charles C. Thomas
, 1975
.8.
Russel
WR
, Schiller
F
. Crushing injuries to the skull: clinical and experimental observations
. J Neurol Neurosurg Psychiatry
0022-3050 1949
;12
:52
–60
.9.
Fuchs
T
, Kachelriess
M
, Kalender
WA
. Technical advances in multi-slice spiral CT
. Eur J Radiol
0720-048X https://doi.org/10.1016/S0720-048X(00)00269-2 2000
;36
(2
):69
–73
.10.
Kalender
WA
. Computed tomography
. New York
: Wiley
, 2000
.11.
Thali
MJ
, Yen
K
, Schweitzer
W
, Vock
P
, Boesch
C
, Ozdoba
C
, et al Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)—a feasibility study
. J Forensic Sci
0022-1198 2003
;48
(2
):386
–403
.12.
Thali
MJ
, Yen
K
, Plattner
T
, Schweitzer
W
, Vock
P
, Ozdoba
C
, Dirnhofer
R
. Charred body: virtual autopsy with multi-slice computed tomography and magnetic resonance imaging
. J Forensic Sci
0022-1198 2002
;47
(6
):1326
–31
.13.
Thali
MJ
, Schweitzer
W
, Yen
K
, Vock
P
, Ozdoba
C
, Spielvogel
E
, et al New horizons in forensic radiology: the 60-second digital autopsy-full-body examination of a gunshot victim by multislice computed tomography
. Am J Forensic Med Pathol
0195-7910 2003
;24
(1
):22
–7
.14.
Thali
MJ
, Schwab
CM
, Tairi
K
, Dirnhofer
R
, Vock
P
. Forensic radiology with cross-section modalities: spiral CT evaluation of a knife wound to the aorta
. J Forensic Sci
0022-1198 2002
;47
(5
):1041
–5
.15.
Messerer
O
. Experimentelle Untersuchungen ueber Schaedelbrueche
. Muenchen
: M. Rieger
, 1884
.16.
Patscheider
H
. ZurEntstehung von Ringbrüchen des Schaedelgrundes
. Dtsch Z ges gerichtl Med
0367-0031 1961
;52
:13
–21
.17.
Knight
B
. Forensic pathology
. London
: Edward Arnold
, 1991
.18.
Spasic
P
, Rezic
A
. (The mechanism of ring-fractures of the base of the skull
). Z Rechtsmed
0044-3433 1970
;67
(5
):324
–8
.19.
Voigt
GE
, Skold
G
. Ring fractures of the base of the skull
. J Trauma
0022-5282 1974
;14
(6
):494
–505
.20.
Parizel
PM
, Makkat
S
, Jorens
PG
, Ozsarlak
O
, Cras
P
, Van Goethem
JW
, et al Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)
. Intensive Care Med
0342-4642 2002
;28
(1
):85
–8
.21.
Firsching
R
, Woischneck
D
, Klein
S
, Ludwig
K
, Dohring
W
. Brain stem lesions after head injury
. Neurol Res
0160-6412 2002
;24
(2
):145
–6
.22.
Kalender
WA
, Vock
P
, Polacin
A
, Soucek
M
. [Spiral-CT: a new technique for volumetric scans. I. Basic principles and methodology
]. Rontgenpraxis
0035-7820 1990
;43
(9
):323
–30
.23.
Soucek
M
, Vock
P
, Daepp
M
, Kalender
WA
. [Spiral-CT: a new technique for volumetric scans. II. Potential clinical applications
]. Rontgenpraxis
0035-7820 1990
;43
(10
):365
–75
.24.
Balfe
DM
, Ehman
RL
. The society of computed body tomography and magnetic resonance imaging. Research in CT and MR imaging: 2000 and beyond
. Radiology
0033-8419 1998
;207
(3
):561
–4
.25.
26.
Calhoun
PS
, Kuszyk
BS
, Heath
DG
, Carley
JC
, Fishman
EK
. Three-dimensional volume rendering of spiral CT data: theory and method
. Radiographics
0271-5333 1999
;19
(3
):745
–64
.27.
Snow
RB
, Zimmerman
RD
, Gandy
SE
, Deck
MD
. Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury
. Neurosurgery
0148-396X 1986
;18
(1
):45
–52
.
This content is only available via PDF.
All rights reserved. This material may not be reproduced or copied, in whole or in part, in any printed, mechanical, electronic, film, or other distribution and storage media, without the written consent of ASTM International.
You do not currently have access to this content.
