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BLUNT FORCE TRAUMA TO THE HEAD
 An Ada County Deputy Coroner was dispatched to a local hospital to review the case of a male patient that had been brought to Boise by Life Flight after his pickup truck left the highway and rolled. According to medical records and staff, the patient was comatose when he arrived at the hospital and remained so. A CT (Computed tomography - a medical imaging method employing tomography. Digital Geometry Processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation)was performed that showed a closed head injury with a Subdural Hematoma and chest injuries that involved several fractured ribs on the left side with a left Pneumothorax (collapsed lung). After review of tests and records, the physician talked with family concerning the severity of the injuries and the decision to provide comfort care only. The family agreed and comfort measures (medication for pain - no life support or surgical intervention) were initiated. The patient expired a short time later. Cause of Death: Blunt Force Trauma to the Head – Motor Vehicle. Manner of Death: Accident.
What is blunt force trauma?
Blunt force trauma is kind of an umbrella term. It is non-specific but sufficient enough to put on a death certificate. However, it can take many forms. A blunt object striking some part of the body causes blunt force trauma. The blunt object may be a bat, wrench, hammer, floor, dashboard, etc. The typical signs of blunt force trauma include lacerated major blood vessels or aorta, lacerated or crushed organs, hematoma, crushed or severed spinal cord or fractures of the skull. Any one of these injuries is sufficient to cause death.
 While automobile accidents and accidental falls represent the greatest causes of blunt force trauma, this type of injury is also present in a wide variety of homicide cases when gunshot wound is not the cause of death. Most homicides involving blunt force trauma result from the victim being struck in the head or neck with an object such as a hammer, fireplace poker, flower vase, etc. In these cases the bones of the skull or neck are fractured in one or more places by the velocity of the blow. Blunt force trauma can also occur if the victim has been severely beaten with an object or with fists. In these cases the injuries are generally to internal organs like the kidneys, liver, spleen, etc.
Blunt Force Trauma to the Head
The brain can be damaged by trauma in two ways. When the head is struck by a hard object, the cerebral cortex (gray matter) can become bruised. If the force of the blow is sufficient to cause a whiplash like circumstance then the injury can occur to the nerve cells (axonal injury) deep in the white matter of the brain. Injury of this type involves a variety of forces including the acceleration of the object and the acceleration force imparted to the brain by the object. Injury results from the direct contact between the object and the head and the greatest injury to the head occurs from the initial direct impact with the blunt object. The area of contact may be large (a baseball bat, 2x4) or small (hammer head, a paper weight) but the velocity of the impact will largely determine the extent and type of damage caused by the resulting blow.
The cranium, the complex structure of bones that encloses and protects the brain, is composed of three layers; the outer table (hard outer layer of bone), the inner table (inner layer of hard bone), and the diploe or spongy bone layer between the two. When the blunt object comes into contact with the bones of the human skull several reactions are possible. A piece of bone may break loose from the skull and be forced into the cranium with concentric fractures forming around the break area. This bone fragment or plug as it is called often takes on the approximate shape of the object itself. Another reaction is where the object causes an inward bending of the skull resulting in crushing of the outer table and diploe with fractures radiating outwards. In this case the inner table is left untouched by the blow. A blow can also cause a situation where there is both inward and outward bending of the skull structures. In this case, the inner table as well as the outer table and diploe are all shattered. Radiating fractures spread outward from the impact site.
 A subdural hematoma (Subdural haematoma) (SDH) is a form of traumatic brain injury in which blood gathers within the inner meningeal layer of the dura (the outer protective covering of the brain). Unlike in epidural hematomas, which are usually caused by tears in arteries, subdural bleeding usually results from tears in veins that cross the subdural space (see photo/arrow). Subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Acute subdural hematoma (ASDH) has a high mortality rate and is a severe medical emergency.
BLUNT FORCE TRAUMA TO THE HEAD
An Ada County Deputy Coroner was dispatched to a local hospital to review the case of a male patient that had been brought to Boise by Life Flight after his pickup truck left the highway and rolled. According to medical records and staff, the patient was comatose when he arrived at the hospital and remained so. A CT (Computed tomography - a medical imaging method employing tomography. Digital Geometry Processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation)was performed that showed a closed head injury with a Subdural Hematoma and chest injuries that involved several fractured ribs on the left side with a left Pneumothorax (collapsed lung). After review of tests and records, the physician talked with family concerning the severity of the injuries and the decision to provide comfort care only. The family agreed and comfort measures (medication for pain - no life support or surgical intervention) were initiated. The patient expired a short time later. Cause of Death: Blunt Force Trauma to the Head – Motor Vehicle. Manner of Death: Accident.
What is blunt force trauma?
Blunt force trauma is kind of an umbrella term. It is non-specific but sufficient enough to put on a death certificate. However, it can take many forms. A blunt object striking some part of the body causes blunt force trauma. The blunt object may be a bat, wrench, hammer, floor, dashboard, etc. The typical signs of blunt force trauma include lacerated major blood vessels or aorta, lacerated or crushed organs, hematoma, crushed or severed spinal cord or fractures of the skull. Any one of these injuries is sufficient to cause death.
While automobile accidents and accidental falls represent the greatest causes of blunt force trauma, this type of injury is also present in a wide variety of homicide cases when gunshot wound is not the cause of death. Most homicides involving blunt force trauma result from the victim being struck in the head or neck with an object such as a hammer, fireplace poker, flower vase, etc. In these cases the bones of the skull or neck are fractured in one or more places by the velocity of the blow. Blunt force trauma can also occur if the victim has been severely beaten with an object or with fists. In these cases the injuries are generally to internal organs like the kidneys, liver, spleen, etc.
Blunt Force Trauma to the Head
The brain can be damaged by trauma in two ways. When the head is struck by a hard object, the cerebral cortex (gray matter) can become bruised. If the force of the blow is sufficient to cause a whiplash like circumstance then the injury can occur to the nerve cells (axonal injury) deep in the white matter of the brain. Injury of this type involves a variety of forces including the acceleration of the object and the acceleration force imparted to the brain by the object. Injury results from the direct contact between the object and the head and the greatest injury to the head occurs from the initial direct impact with the blunt object. The area of contact may be large (a baseball bat, 2x4) or small (hammer head, a paper weight) but the velocity of the impact will largely determine the extent and type of damage caused by the resulting blow.
The cranium, the complex structure of bones that encloses and protects the brain, is composed of three layers; the outer table (hard outer layer of bone), the inner table (inner layer of hard bone), and the diploe or spongy bone layer between the two. When the blunt object comes into contact with the bones of the human skull several reactions are possible. A piece of bone may break loose from the skull and be forced into the cranium with concentric fractures forming around the break area. This bone fragment or plug as it is called often takes on the approximate shape of the object itself. Another reaction is where the object causes an inward bending of the skull resulting in crushing of the outer table and diploe with fractures radiating outwards. In this case the inner table is left untouched by the blow. A blow can also cause a situation where there is both inward and outward bending of the skull structures. In this case, the inner table as well as the outer table and diploe are all shattered. Radiating fractures spread outward from the impact site.
A subdural hematoma (Subdural haematoma) (SDH) is a form of traumatic brain injury in which blood gathers within the inner meningeal layer of the dura (the outer protective covering of the brain). Unlike in epidural hematomas, which are usually caused by tears in arteries, subdural bleeding usually results from tears in veins that cross the subdural space (see photo/arrow). Subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Acute subdural hematoma (ASDH) has a high mortality rate and is a severe medical emergency.
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