Blunt Head Trauma

Blunt trauma to the scalp and face can produce contusions, lacerations, and abrasions. However, there may be no external signs of trauma to the head if a person has a full head of hair. Obvious external injuries are not necessary for a death to be caused by head trauma. Occasionally, the weapon leaves a characteristic identifying pattern on the scalp. Unfortunately, this is the exception rather than the rule.

Battle's sign — a bluish discoloration of the skin behind the ear that occurs from blood leaking under the scalp after a skull fracture.

Spectacle hemorrhage (raccoon's eyes) — a discoloration of the tissues around the eyes usually due to a fracture of the skull. The hemorrhages may involve one or both eyes and may be mistakenly interpreted that the decedent had been struck about the face and eyes.

When a person receives a significant blow to the head there will be bleeding under the scalp even if there are no external injuries. Depending on the amount of force there may be skull fractures. There are many different types of skull fractures; however, the specific type is not as important as recognizing a pattern such as a circular fracture caused by a hammer.

There are three major types of hemorrhages which occur in the skull. The type of hemorrhage helps the examiner understand what may have caused death.

1) Epidural hemorrhage — bleeding directly under the skull on top of the dura mater. It is associated with a skull fracture and a torn artery. This type of hemorrhage accumulates rapidly and death may occur quickly.

2) Subdural hemorrhage — bleeding under dura mater on top of the brain. It may or may not be associated with trauma and is caused by torn veins which forces the blood to accumulate more slowly than the epidural bleed.

3) Subarachnoid hemorrhage — caused by blunt trauma or ruptured blood vessels. It is located directly on the surface of the brain.

Pathologists also look for the presence of coup and contrecoup injuries to the brain to help differentiate between a fall and a blow to the head by a second party.

Coup injury — caused when a moving object (such as a hammer) strikes a stationary head. The injuries to the brain will be directly beneath the point where the weapon strikes the head.

Contrecoup injury — caused when a moving head (as in a fall) strikes a stationary object like the floor. The injuries to the brain will be opposite the point of impact.

Wounds Blunt Object
FIGURE 3.1 The bruises on this woman's arm appear as if made by fingers. The man who killed the woman made the bruises. There is no way to determine the size of the hand or the strength it took to cause the bruises.
Traumatic Gunshot WoundsPics Gunshot Wounds The Head

FIGURE 3.2 The black eye looks recent because of its color. It is one week old. People bruise and heal differently. Determining the age of a bruise is difficult.

FIGURE 3.3 Bruises (contusions) change color as they heal. They may progress from red/blue, green, brown to yellow, as they heal. Unfortunately, all contusions do not resolve the same. The multicolored bruise in this photograph is exactly one week old.

Unexplained Bruises Leg Old People
FIGURE 3.4 Older people bruise easily. They may have many bruises of the arms and legs. These are not necessarily suspicious.
Gunshot Wounds Pictures
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