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  1. #1

    Default Autopsy questions

    From Anna Nicole Smith's autopsy report (bold type mine):
    The scalp has no hemorrhage or contusions. The calvarium is intact. There is no epidural, subdural or subarachnoid hemorrhage. The brain has a normal convolutional pattern and weighs 1300 grams. The meninges are clear. The cortical surfaces of the brain have mild to moderate flattening of the gyri with narrowing of the sulci.The brain is cut after formalin fixation and a separate neuropathology report is attached.

    http://www.pathguy.com/anna.autopsy.pdf
    In JonBenet's autopsy report, flattening of the gyri and narrowing of the sulci are mentioned also, and it was said that this indicated brain swelling. I haven't followed the Anna Nicole Smith case, but it seems she died from medication overdose and had no head injury. .

    It would interest me why "flattening of the gyri and narrowing of the sulci" are mentioned at all in an autopsy report, i.e. is "flattening of the gyri and narrowing of the sulci" a pathological condition or not?

    Or to ask differently: do there exist 'unflattend gyri' and 'un-narrowed sulci' also? Is this the normal medical condition?

    - What exactly does flattening of the gyri and narrowing of the sulci mean medically speaking? What causes it?
    - Can a brain also swell without there being a head injury (for example from medication overdose like in Anna Nicole Smit's case)?

    TIA for helping to answer these questions.

  2. #2
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    Default This may be helpful.

    Anoxia/Hypoxia
     Defined:
    – Anoxia-Complete loss of oxygen to the brain
    – Hypoxia-Partial loss of oxygen to the brain
    Mechanisms of cell death
     Anoxia interferes with the function of neurons causing swelling of mitochondria due to loss of their ability to process glucose and lack of energy production for the use of other organelles and membranes in the cells.
    •Neurons are most susceptible to anoxia followed by oligodendroglia, astrocytes and connective tissue.,
    The brains of patients who become anoxic are usually swollen with flattening of the gyri and narrowing of the sulci and decreased size of the ventricles.
    The Anoxic Brain
    Common Causes
     Stroke
     Heart Attack/Arrhythmia
     Trauma-lungs/body core
     Near Drowning
     Carbon Monoxide
     Shock
    Autoregulation
     Attempt by brain to maintain homeostasis
     If damage occurs to core of body and large blood loss occurs, brain vessels alter size and function to maintain blood supply as long as possible
    Greatest Susceptibility
     Hippocampus
     Basal Ganglia
     Purkinje Cells of Cerebellum
     Occipital/Parietal lobe
     Cerebral Cortex

    The full document:
    http://clem.mscd.edu/~lockwool/clin/Anoxia.rtf

    Looks like coma and oxygen deprivation is what causes the gyri to flatten, and it doesn't seem to be injury-dependant.
    "We're not necessarily doubting that God will do the best for us; we are wondering how painful the best will turn out to be." - C.S. Lewis

    MY OPINIONS - DO NOT COPY THEM ANYWHERE ELSE ON THE INTERNET!

  3. #3
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    Default

    Flattening and narrowing of the gyri, sulci as well as of the gimble and the wabe are typical of female brains.

  4. #4
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    Default

    Paradox, you are skating on very thin ice here.

    :bigstick:
    "We're not necessarily doubting that God will do the best for us; we are wondering how painful the best will turn out to be." - C.S. Lewis

    MY OPINIONS - DO NOT COPY THEM ANYWHERE ELSE ON THE INTERNET!

  5. #5

    Default

    Quote Originally Posted by Paradox
    Flattening and narrowing of the gyri, sulci as well as of the gimble and the wabe are typical of female brains.
    Man o man, you would fit in well as a guest of the Hatter and the March Hare in Alice in Wonderland.

    And while you move around in paradoxical Wonderland, you should also take a closer look at Humpty Dumpty who said:

    "Twas brillig, and the slithy toves
    did gyre and gimble in the wabe:
    all mimsy were the borogoves
    And the mome raths outgrabe."


    Paradox, I'm sure there are 'secret clues' in Humpty Dumpty's poem. BTW, has his alibi been checked for Dec 26th/06? See, another blunder by the Boulder cops, overlooking him. Imo you should add Humpty to your list of supects next to Sandy Stranger. I never trusted that egg-shaped creature anyway.

  6. #6
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    Default

    Humpty Dumpty said that, rashomon? I think I just fell through the ice.
    elle: The RST can't handle the truth!
    Just my opinion.

  7. #7

    Default

    Quote Originally Posted by Elle_1
    Humpty Dumpty said that, rashomon? I think I just fell through the ice.
    Humpty Dumpty explained the meaning of the poem which Alice recited - sorry, my goof.

    [P.S. I have received your test email, and have copied and pasted mine again into the reply - I hope it will go trough this time ].

  8. #8
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    Default

    Quote Originally Posted by rashomon
    Man o man, you would fit in well as a guest of the Hatter and the March Hare in Alice in Wonderland.

    And while you move around in paradoxical Wonderland, you should also take a closer look at Humpty Dumpty who said:

    "Twas brillig, and the slithy toves
    did gyre and gimble in the wabe:
    all mimsy were the borogoves
    And the mome raths outgrabe."


    Paradox, I'm sure there are 'secret clues' in Humpty Dumpty's poem. BTW, has his alibi been checked for Dec 26th/06? See, another blunder by the Boulder cops, overlooking him. Imo you should add Humpty to your list of supects next to Sandy Stranger. I never trusted that egg-shaped creature anyway.
    This is what narrowing and flattening of the gyri and sulci does to women.

  9. #9

    Default

    Quote Originally Posted by Paradox
    This is what narrowing and flattening of the gyri and sulci does to women.
    LOL, touché, Paradox - good retort, I'll have to give you that.
    Now that Humpty has been cleared as a suspect, and Alice has never been "under the umbrella" anyway, we're back to square one.
    Last edited by rashomon; January 24, 2008, 5:14 pm at Thu Jan 24 17:14:14 UTC 2008.

  10. #10

    Default

    Quote Originally Posted by heymom
    Anoxia/Hypoxia
     Defined:
    – Anoxia-Complete loss of oxygen to the brain
    – Hypoxia-Partial loss of oxygen to the brain
    Mechanisms of cell death
     Anoxia interferes with the function of neurons causing swelling of mitochondria due to loss of their ability to process glucose and lack of energy production for the use of other organelles and membranes in the cells.
    •Neurons are most susceptible to anoxia followed by oligodendroglia, astrocytes and connective tissue.,
    The brains of patients who become anoxic are usually swollen with flattening of the gyri and narrowing of the sulci and decreased size of the ventricles.
    The Anoxic Brain
    Common Causes
     Stroke
     Heart Attack/Arrhythmia
     Trauma-lungs/body core
     Near Drowning
     Carbon Monoxide
     Shock
    Autoregulation
     Attempt by brain to maintain homeostasis
     If damage occurs to core of body and large blood loss occurs, brain vessels alter size and function to maintain blood supply as long as possible
    Greatest Susceptibility
     Hippocampus
     Basal Ganglia
     Purkinje Cells of Cerebellum
     Occipital/Parietal lobe
     Cerebral Cortex

    The full document:
    http://clem.mscd.edu/~lockwool/clin/Anoxia.rtf

    Looks like coma and oxygen deprivation is what causes the gyri to flatten, and it doesn't seem to be injury-dependant.
    Thanks so much heymom for the info. So oxygen deprivation can cause brain swelling too - very interesting.

    Re JB's head wound: IDIs have brought up the argument that, if JonBenet had been alive for some time after the head blow, her brain should have shown more swelling than just 'mild' flattening of the gyri.
    But does a brain always swell a lot after a head trauma?

  11. #11
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    Default

    It depends. Of course, with any head injury, swelling is always limited by the skull, so the brain can only expand so far. That's why doctors will cut a piece of skull out or put shunts in if someone has a serious injury, so the brain can swell up without causing further injury to itself.

    JonBenet's injury would have caused a lot of brain swelling, I believe. As much as would be possible with that kind of fracture, again allowing for the limitation of the skull. It was a very extensive fracture. Then again, wasn't there a displacement of a piece of the skull? If so, the brain could have expanded in that area and some of the pressure against the skull could have been relieved.
    "We're not necessarily doubting that God will do the best for us; we are wondering how painful the best will turn out to be." - C.S. Lewis

    MY OPINIONS - DO NOT COPY THEM ANYWHERE ELSE ON THE INTERNET!

  12. #12

    Default

    Quote Originally Posted by heymom
    It depends. Of course, with any head injury, swelling is always limited by the skull, so the brain can only expand so far. That's why doctors will cut a piece of skull out or put shunts in if someone has a serious injury, so the brain can swell up without causing further injury to itself.

    JonBenet's injury would have caused a lot of brain swelling, I believe. As much as would be possible with that kind of fracture, again allowing for the limitation of the skull. It was a very extensive fracture. Then again, wasn't there a displacement of a piece of the skull? If so, the brain could have expanded in that area and some of the pressure against the skull could have been relieved.
    Yes, a rectangular piece of bone had been punched out. But the autopsy report doesn't mention any other brain swelling/expanding aside from the mild flattening of the gyri and narrowing of the sulci.
    If the brain had expanded through the punched out piece of bone, wouldn't the coroner have noticed a 'bump' from the outside before cutting up the scalp?



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