Time span between head blow and strangulation

Discussion in 'Justice for JonBenet Discussion - Public Forum' started by rashomon, Jan 27, 2007.

  1. rashomon

    rashomon Member

    Are there any people with medical knowledge here or who could ask doctors (esp. hematologists or trauma specialists) about this:

    1) A poster on the Crimelibray site wrote that in case a child sustained an injury of the type JB had, and the wound did not kill the child right away, her head would swell to double its size in a time span of 20 - 60 minutes.
    True or false?

    This poster claims to be an ER doc, and sounds very credible imo.
    But the problem in the JBR case is that even doctors seem to disagree about the forensic evidence.

    2) This poster also pointed out the autopsy report which states that some of the blood in JB's head shows little signs of organization. 'Organization' is a medical term meaning hemostasis (blod clotting), which sets in immediately after an injury as the body's attempt to save itself from bleeding to death.
    The lack of organization, this poster wrote, would also indicate that JB ws strangled immediately after the head blow, since the blood in her brain had no time to clot.

    3) Another claim: a person has to be breathing vigorously for petechiae to occur. True or false?

    The bottom line of this poster's argumentation is that the medical evidence makes a scenario likely where the cord was put around JB's head immediately after the head blow.
    But I find it hard to imagine that a parent would switch from 'rage attack mode' into 'staging mode' in a matter of minutes.
    But still it keeps bugging me why the blood in JB's brain did not have time to clot. But maybe JB was 'more dead than alive' after the head blow and her bodily functions couldn't even manage blood clotting anymore?

    Therefore my question:

    Does there exist a stage where a person is not yet dead but the bodily functions are already too impaired to develop hemostasis? A stage where the (still alive) body is just not able to kick into high gear anymore in an attempt to save itself?
     
  2. The Punisher

    The Punisher Member

    Her brain certainly swelled a great deal!

    Actually, Tom Henry, one of the specialists who said ten to 45 minutes, characterized it as exactly that: a blood clot.

    I don't know.

    You just nailed it. She went into shock, and shock can shut down the body's functions very drastically.

    Not only that, but remember what Spitz said? About how the killer likely twisted the shirt collar first?
     
  3. sue

    sue Member

    The blood in JB's brain did clot because the autopsy shows some clots and also some fresh hemmorhage. That doesn't necessarily mean that she died within a minute or two of the head injury. It may just mean that the bleeding continued after the initial injury.
    The person on that other forum who said her blood did not clot is not really correct. He appears to think organization and clotting are the same thing - they are not.
    The question of "organization" was covered very well in this thread on page 38.

    In that thread on that page, I posted a link to a study of people with brain hemorrhages (bleeding in the brain)and wrote this:
    I think Texan had posted some stuff about petechiae in that same thread.

    For the question of the head swelling, for the type of injury she had, there was little swelling outside the head (which seems to be what that person was talking about.) Most of the head injury patients in the hospital where I work did NOT have visible swelling of their heads from the records we get. In fact, most of their heads looked faily normal until they did MRIs or brain scans (we are Rehab, so we see them after they are past the immediate injury stage and they are stable enough for Rehab - but wee have their records). Swelling of the brain can take place completely inside the skull. When there is enough swelling, the brain can't function.
    __________________
     
  4. tylin

    tylin Banned

    I called a close friend who is a trama center nurse and asked her about this. She essentially said that Sue is spot on with her information. Many head trauma patients show very little swelling on the outside of the head. Remember the ME wasn't aware of JBR's skull fracture until her skull was exposed during the autopsy.

    I remember there being no indication of a head injury but does anyone remember if there was mention of an indention near the skull fracture?
     
  5. Little

    Little Member

    Great topic and great responses here. I have a question too, was there any bruising or markings on the skull? (for instance, if it was a flashlight, would there be any indication of ridges?) Was there a definite indication of the exact spot the blow landed? I can't recall reading if there was. Tylin asked if there was an indent, that's a good question too.

    My questions are relating to the outside of the skull.

    Little

    Edited to add that my question about markings is relating to the skin & flesh covering the skull.

    Little
     
    Last edited: Jan 28, 2007
  6. wombat

    wombat Member

    Regarding marks from the impact on her skull, I've always wondered what the displaced piece of skull looked like - the oval shaped piece that was pushed into her brain, that we don't see on the autospy photo of her skull. I would imagine if a mark was made, it would be there.
     
  7. rashomon

    rashomon Member

    TP, I think the poster on the CL site was referring to the lack of swelling outside JB's head, and in that poster's opinion there should have be outside swelling too if 20 to 60 minutes elapsed between the head blow and the strangulation. But I just read the answers here, where posters pointed out that most people with head trauma don't show swelling outside the head.
    Thanks to all the posters who have replied and provided this important medical info.

    TP, could you give me the link to Spitz's statement? I remember reading it a while ago, but can't find it right now. TIA.
     
  8. heymom

    heymom Member

    The skull does not allow swelling, that is why doctors have to remove some of it when there is trauma, to allow the brain room to swell and not be constricted (which causes more damage). That is why shunts are put in, to remove fluid which could build up, since the skull would hold it in. To state that a person's HEAD would double in size after a trauma means that person has NO medical knowledge.
     
  9. JustChillun

    JustChillun Member

    Okay, I have seen big heads after trauma, and I have seen regular heads after trauma but they don't get a shunt if it's bad (that's a long term implant item) they get an EVD or a bolt...something that externalizes the fluid for monitoring and where they can connect a manometer to the tubing to measure the pressure.
    Also, I have seen the pressure compressing the brain to the point that the tissues are sort of like a big-holed doughnut on CT, and that is dangerous to tissue survival.
    Brain injury sucks.
     
  10. The Punisher

    The Punisher Member

    ST's book, sweetheart.
     
  11. Cleej2

    Cleej2 Member


    Thanks for the info JustChillin.

    But could you possibly tell us what kind of head injuries would swell and what kind of head injuries might not swell. I mean what specific trauma causes the head to swell? If you could answer that question, it would help. Thanks.
     
  12. Texan

    Texan FFJ Senior Member

    head swelling

    Many years ago my little brother fell out of the car as mom was driving it down the road and rolled all the way across the road in front of oncoming traffic. He then jumped up and ran back across the road, again in front of oncoming traffic. How he survived we just don't know, but he was one of those accident-prone children that seem to survive against the odds. Anyway, the top of his head was so swollen he looked like an alien. The doctor put 5 staples in his head and sent him home. He was fine.

    I don't think there was any brain swelling, I think it was just his skin and subcutaneous tissue that swelled up. It was quite impressive.
     
  13. Cleej2

    Cleej2 Member


    Thank God he was relatively ok Texan. But what happened here if you don't mind telling us? What caused the injury? Was he hit by a car? Please explain a little more. Thanks
     
  14. koldkase

    koldkase FFJ Senior Member

  15. koldkase

    koldkase FFJ Senior Member

    To answer the question about the outer condition of the scalp, I'm just reading this in the autopsy...for the thousandth time (I should know it by heart by now):

    http://www.acandyrose.com/12271996jonbenet04.gif

    From the section of the autopsy entitled "REMAINDER OF EXTERNAL EXAMINATION":

    Here is the description of the inner exam, or what the medical examiner discovered when he pulled the scalp back:

    http://www.acandyrose.com/12271996jonbenet07.gif

     
  16. Elle

    Elle Member

    Yes, Wombat, because that's the piece that's missing. Haven't heard any more on this part.
     
  17. Elle

    Elle Member

    What would be do without medical personnel like you, JustChillun? My hat is off to you.
     
  18. Elle

    Elle Member

    <TABLE cellSpacing=0 cellPadding=6 width="100%" border=0><TBODY><TR><TD class=alt2 style="BORDER-RIGHT: 1px inset; BORDER-TOP: 1px inset; BORDER-LEFT: 1px inset; BORDER-BOTTOM: 1px inset">Originally Posted by Texan
    Many years ago my little brother fell out of the car as mom was driving it down the road and rolled all the way across the road in front of oncoming traffic. He then jumped up and ran back across the road, again in front of oncoming traffic. How he survived we just don't know, but he was one of those accident-prone children that seem to survive against the odds. Anyway, the top of his head was so swollen he looked like an alien. The doctor put 5 staples in his head and sent him home. He was fine.

    I don't think there was any brain swelling, I think it was just his skin and subcutaneous tissue that swelled up. It was quite impressive.

    </TD></TR></TBODY></TABLE>

    Oh good grief, Texan. That's quite a story. So glad he was a tough little nut. :) How is he today?
     
  19. Texan

    Texan FFJ Senior Member

    little brother, Jon

    He wasn't hit by any car, by some miracle. The head swelling was caused by contact with the road. He is as mentally normal as anyone in our family can be. :winko: He is a paramedic, has been the chief medical officer at a prison, and currently is a deputy sheriff and on the county swat team.(following in the footsteps of our daddy, who was in law enforcement for many years)) But he carries a pack with him so when the shooting is over he can render medical treatment to whoever gets shot.
     
  20. Cleej2

    Cleej2 Member


    Thanks Texan. Little brother Jon is BIG in my eyes. Thanks for the rest of the story.
     
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