The Alleged “Skull X-rayâ€

Cynic, we're gonna have to start coordinating with one another so we don't duplicate each other's efforts.

Well, okay, I'll grant them a special dispensation based on good intents if you and Cherokee BOTH feel that was the reason (although I still have doubts considering the extent to which they went to make it look like a genuine radiograph).

:thumbsup:

Thank you for the addition, cynic. I could see what had happened with the shadow in the back, but couldn't separate it with my software.

Do you agree with my belief about that "bridge" of flesh at the back of the depressed fracture? If it is not used to create the two niches, the remaining area is almost a perfect oval. This is making me take another look at a baseball bat after believing for better than ten years that a putter had caused the fracture -- and it's the reason I hadn't yet committed on the golf club thread. But no doubt in my mind, the flashlight is a no-go.

 

Well, then I guess we know what country it was either recorded in or that it was broadcast from. Kind of eliminates the rest of the world, eh?

 

otg, your research and explanation are simply amazing. Thank you!

 

Ha ha, you're right about that!

You and Cynic have done an amazing job. We have so many good people on this forum who have contributed greatly to our knowledge of the Ramsey case. FFJ posters rock! :headbang:

 

I also commend you on your excellent work on this, otg. I'm going to study it more closely when I have time, because I recently was working with this "comminuted fracture" myself, and I couldn't get the proportions of the photo to match the description from the autopsy report, though I couldn't understand why. Now I think it's because of the "pulp" which I used in my measurements, which in fact may not be part of the fracture at all--and thanks so much for working so hard to figure that out for us! :takeabow:

One thing: this screen capture taken from the NBC program which aired about the case could be an ACandyRose screen capture, as she used to do a lot of them for us. Why Nut also did some.

Also good work, as ever, cynic.

I haven't ruled the ballbat out yet. I had even thought of making a "to scale" picture to compare to the "knob" of a women's league softball bat, which I think is what the bat was which was found on the north side of the house. It was metallic, if memory serves. I once spent some time trying to figure out the logo of the bat, but had no luck as I'm not a sports person and finally got tired of it. But the metal bat always kept my interest because it was found on a concrete section of patio near the butler door, and it put me in the mind of the neighbor who thought he heard some kind of metal scraping that morning, after his wife said he heard a "child's scream."

Of course, the "knob" end of the bat would not necessarily be the end used, but the fuller end seemed to be too large. However, I never made a comparison, and I was working to do that when I couldn't get the dimensions of the skull fracture to work out with the autopsy report, so I put it away for later.

Then I was about to let that go entirely, as the work y'all did on the golf club indention was so close, it seemed that was looking like more of a sure bet, especially with the blond hair found on one outside.

Anyway, I won't be able to get to it for a few weeks, so if anyone else is working on that, I'm happy to defer to the excellent imagination and research you all have shared with us here. Namaste.

 

As many of you know, I'm a medical imaging technologist so I'll include a few comments.

1. Remember that, when you look at the regular skull xray images, you're looking at an image which has superimposed the entire skull with the brain in place. For instance, when you're looking at a lateral skull image (a side view of
the skull), the energy has passed through one side of the skull, through the brain and then through the opposite side of the skull and all of this information is superimposed upon the image. The side of the skull, which has been injured, will best be evaluated when that side of the skull is closest to the image receptor or film. In other words, if I have a hairline fracture above my right ear, that fracture will best be seen if my head is lying on it's right side closest to the film or receptor. Yet, all the information is superimposed on this image. Now, the brain doesn't show up on a regular radiograph but it does absorb and scatter some of the xray energy thereby smoothing out some of the subtle thickness differences in the skull. Which leads to point # 2.

2. The image which, at first glance, looks like a radiographic image, would have been taken without the brain and a superimposition of opposite sides of the skull. In other words, if a radiograph was taken, the energy passed only through one piece of bone. This would enhance the subtle differences in cranium thickness seen on the radiograph. But....but.... As otg mentioned, these darker areas, in this image, coincide with areas where there is less blood or remnants of scalp. So.

3. This leads me to believe that the image is not a radiograph but I'm not 100% certain and I'll explain why.
In this shell of a skull, less energy would be used and when less energy is used, radiographic contrast is increased.
I doubt if this would be enough to explain the contrast we see between the areas where blood and scalp are present and where it is absent. Could the blood and scalp remnant absorb that much energy? I doubt it but I've also never imaged a shell of a skull so, although I'm almost certain it's not a radiograph, I wouldn't bet my life on it.

And, as otg mentioned, why would they have a need to image this skull when they can visually inspect it? It's most likely some imaging technique to remove the grisly parts and enhance the fracture for viewers. But.....

4. I do believe this image does represent an accurate portrayal of the comminuted depression fracture with the resulting linear fracture which courses anteriorly for about 8 inches. But, I agree with otg that the skull depression is oval in shape. The other comminutions, and small fracture lines, adjacent to the oval depression, are a result of coincidence and have nothing to do with the shape of the blunt object. The blunt object was oval in shape or very near.

 

Thank you, Learnin, for being a medical imaging technologist and for this terrific information. It is good to have a medical technologist on hand when one needs one and doesn't fully understand some of the technical jargon.

 

And thank you, Elle, for always providing interesting and kind observations.

 

Thank you Learnin! I didn't know you were a medical imaging technologist! Thank you for weighing in on this!

 

Oh, my, Learnin! I didn't know this is what you do. I'm certainly glad you weighed in on it.

I understand what you're saying in Item-1 about the crack having the best resolution if it is closer to the film. There is probably a term for it, but it's the same principle as making hand silhouettes in a bright light. If your hand is close to the wall that the shadow is projected on, the shadow is sharp. If your hand is further away from the wall (closer to the light source), the shadow will be larger and blurred on the edges. With a radiograph, you would want the area of interest to be closest to the recording film.

This is one more reason to be suspicious of the alleged X-ray. Since you are familiar with it, can you imagine that the skull would be shot at such an angle that the projected image on the film would look the same as the photograph? And wouldn't it also be reversed (unless it was shot from the top with the film on the bottom -- in which case the fracture would lose the sharp definition on the film)?

Thanks for your input, Learnin. I really appreciate getting feedback from an expert (and I didn't know we had one on this).

 

You're welcome, Karen.

 

You're welcome, otg. Your analogy with the shadow is pertinent. Magnification is the principle involved here. The further away the object is away from the receptor (or film), the more magnified the object. The more magnification, the less resolution or sharpness....like being out of focus. Which brings me back to the hairline fracture. If it is above the right ear, then, you will probably see it on a radiograph if the left side is closest to the receptor but it will be magnified and not as sharp. It's even possible, if the hairline fracture is real tiny, that you could miss it altogether.

Which brings us back to the image in question. Yes, if this represents a radiograph, then, the energy source was above the skull with the skull resting on the film. Since the fracture is along the top of the skull, it would mean that the fracture was what, about at least 3-4 inches above the film? This would result in some magnification of that fracture line. Which would be an interesting study if one could know the accurate scale. If the fracture, on the supposed radiograph, is an eighth of an inch or thereabouts larger than the actual skull fracture, then, you could almost bet it is a radiograph.

 

Sounds good to me.

I disagree slightly about the “bridge†part.
I would call it more of demarcation line.
After looking at the image through a number of digital filters and enhancement techniques it looks to me as if there are areas where tissue has been completely peeled away and areas where it is quite noticeably present.
In the first of two pictures below I have circled two areas in yellow which I believe are devoid of tissue. The left edge of the larger area is the portion that you are inquiring about.
You can see that it is more that a thin strip or bridge because that strip is the beginning of considerable “blurring†as you move left toward the back of the skull.
Of course some of the blurring is due to what looks to be a fairly shallow depth of field in the picture with respect to the sharpest point of focus near the right edge of the depressed fracture. Even with that taken into consideration you can see that the blurring is immediate and consistent beginning with the “bridge.â€
The blurring, then, I believe, is primarily the result of looking through tissue.
With respect to the shape of the fracture, I believe it is what it is, and defies a specific description other than an irregular ovoid. I also think that small fragmentation which may account for some of “odds and ends†in the fracture may not have been specifically documented by Meyer, but included within the general term, comminuted fracture.

 

I would like to congratulate cynic and otg for all the interesting information they have both produced and for their good manners in handling this situation. Naturally, it's way over my head. I wondered how they were both going to deal with this because their work was very similar. I would say they both did a great job without jealousy showing. This is very rare these days. I wish them both all the best and thank them for all the time taken with their excellent posts.

 

Cynic, thanks for enlarging the skull photos - somehow, I had never realized that the back part of the fracture is indeed, very blurry compared with the rest of the fracture.

Learnin thanks for your contribution to the thread.

And otg, you too have added a tremendous amount to our knowledge base here at FFJ!

:highfive::bow:

 

To gain some perspective in terms of how much of the skull cap we are seeing, here is a depiction of the autopsy procedure to peel the scalp and cut away the skull cap.

*CAUTION – A BIT GRAPHIC*

INCISION OF SCALP: The head is elevated slightly with a wooden block or a metal headrest attached to the autopsy table. The hair is parted with a comb along a coronal plane connecting one mastoid with the other over the convexity (Fig. 4-1). A sharp scalpel blade can then be used to cut through the whole thickness of the scalp from the outside. The incision should start on the right side of the head (the "viewing-side" in most American funeral parlors) just behind the earlobe, as low as possible without extending below the earlobe, and extend to the comparable level on the other side. This will make reflection of the scalp considerably easier. Sufficient tissue should be left behind the ear to permit easy sewing of the incision by the mortician. The anterior and posterior halves of the scalp are then reflected forward and backward, respectively, after short undercutting of the scalp with a sharp knife, which permits grasping of the edges with the hands. The use of a dry towel draped over the scalp edges facilitates further reflection, usually without the aid of cutting instruments. If the reflection is difficult, a scalpel blade can be used to cut the loose connective tissue that lags behind the reflecting edge as the other hand continues to peel the scalp. The knife edge should be directed toward the skull and not toward the scalp. The anterior flap is reflected to a level 1cm or 2cm above the supraorbital ridge. The posterior flap is reflected down to a level just above the occipital protuberance.
SAWING OF CRANIUM: The cranium is best opened with an oscillating saw.
[SNIP]
Various saw cuts are in use but we recommend the method illustrated in Fig. 4-3. The configuration of the saw cut minimizes slippage of the skull cap during restoration of the head by the embalmer. Naturally, the saw cut may have to be modified after some neurosurgical procedure(s) or in the presence of skull fracture(s).
[SNIP]
The frontal point of sawing should start about two fingerbreadths above the supraorbital ridge. While the lateral aspects of the skull are being cut, turning the head to the opposite side permits the brain to sink away from the cranial vault and thereby diminishes the chance of injury to the brain. When the dura is left intact, as in the method described earlier, the skull cap can be peeled away easily. A twist of a chisel placed in the frontal saw line will admit the fingers inside the skull cap. A blunt hook may be used to pull the skull cap away from the underlying dura. A hand inserted between the skull and the dura (periosteum) helps the blunt separation of these while the other hand is pulling the skull cap. If the dura adheres too firmly to the skull, it can be incised along the line of sawing and the anterior attachment of the falx to the skull can be cut between the frontal lobes.



Handbook of Autopsy Practice, 4th Ed., Brenda L. Waters, MD, pages 52-53

 

Wow! how impressive.
brenk

 

Thank you so much, cynic, for the contributions and the help.

Ya’ know... I hadn’t even thought about how the brain was removed (in this particular case), even though I had read about autopsy procedures. Part of the reason, I guess, is that Meyer mentions reflection of the scalp in his discovery of the head blow injuries. But he doesn’t mention sawing the skull before examination of the brain, and the sawed edges do not show up in the photo. So my incorrect assumption in my post on the golf club thread was that the photo was of the entire upper portion -- the neurocranium.




So of course I had to make sure this miscalculation on my part didn’t affect the location of the depressed fracture.

It doesn’t. The illustrated saw cut is almost parallel with the natural bottom of the braincase, and I had shown the position of the fracture based on the autopsy description.





This is the image from my earlier post (reversed) with the line formed at the natural bottom of the braincase in red, and the saw cut from above added in blue (as close as I can draw it):

ITA with that. But I would add that this is probably the reason that this “bridge” of flesh occurred. It looks like it coincides with where the initial cut of the scalp (the “coronal plane of the primary incision”) was made. After that incision was made, the front of the scalp was pulled forward, and then the back part of the scalp was pulled back. When the back part was pulled, it might have left a small layer of flesh behind that was not left behind on the front part. (I hope this is making sense -- remember, I’m medically challenged.) Evidence of this is the white glistening effect of the moist flesh running across the open area of the hole in the skull.

So I guess what it comes down to is whether these two darker areas that were interpreted before as niches in the skull are indeed that, or flesh that is darker because it is bruised flesh that was left behind. Your point, cynic, is cogent as to the blurriness of the rest of the fracture to the left of this. I believe you are correct that there must be a thin film of flesh remaining in this area (there is also some minor glistening further back). I guess this is something we'll have to leave as a question mark, even though we've come a lot further in understanding details of the fracture.

It’s a shame we can’t know with certainty, and I don’t understand why this flesh wouldn’t have been removed before the photo was taken so the complete fracture would be better defined in the image.

Agreed.

 

Quoting myself to add a big Thank You also to cynic and Learnin. Thanks to all of you for your expertise and analyses. You're awesome!

Learnin, I really appreciated your explanation to my question about the skull fracture on another thread (the "Extra golf clubs seen in Ramsey basement/train room video" thread). I'll quote your post here because it clarified for me how this fracture could've happened: