Ive been meaning for a long time to tackle the subject of Dr. Rorkes estimate, but just hadnt found (or taken) the time.
Mama, your question points out one more reason to doubt the time estimate that has gained so much general acceptance since it was reported by Kolar. TMK, until he wrote about the time estimate given by Dr. Lucy Rorke (-Adams), most other pathologists had all placed a much smaller time frame between the two. In fact, there was even disagreement between some as to which of the two insults came first. Those experts who thought the strangulation came
before the head blow (most prominent among them was Dr. Wecht) usually cited the small amount of brain swelling or the lack of more bleeding as the basis for their opinion. So the question should be (IMO) why put so much credence in this one experts opinion over all others. After all, hers is very different from most of the other opinions. And if it is correct, it completely changes the circumstances that must have happened in order for there to be that long of an interval between the head blow and the strangulation.
I struggled with this revelation for a long time trying to reconcile the implications. Finally, after looking into the variables that should be considered, I found enough reason to justify questioning its validity. I might be accused of trying to fit the evidence to my theory of what happened. Thats a fair enough accusation, but in this case that evidence is only the opinion of one person. The real reason for questioning this is because it is so contrary to everything else that we know (including the opinions of nearly all other experts who have checked in on the subject), and because (like the pineapple) it is so critical to determining the sequence of events that led to JonBenets death.
Something important to consider in trying to decide which experts opinion might be more accurate than anothers is what information he/she had available to them at the time. At a minimum, the expert might have had only the AR on which to base an opinion. (There are some opinions which are still even today circulated that were based on the partial AR that was released before a judge ordered it released in full.) The most information a person could have would be to actually see the evidence firsthand and to have access to the results of any further testing that might be done (chemical, biological, microscopic, etc.). TMK, Dr. Meyer is the only pathologist who had all that. But he is not a neurological pathologist, and his conclusions and opinions have never been made public. Somewhere between those minimum and maximum amounts of information are a few experts like Dr. Rorke who (according to my information) was given access to lab reports, copies of microscopic slides, and even a section of the brain taken and preserved by someone in the MEs office (more on that in another post). Additionally, Rorke is a neuropathologist -- an expert on brain pathology. Her credentials in this field are unquestioned. But her specialty is limited to this area and her knowledge in other areas important to consider might be limited.
Lets look first at what Meyer said in the AR about the amount of swelling in the brain. Ill try to give as much information as I have on this one part of the time estimate, and then Ill write about
necrosis -- the other factor reportedly looked at by Dr. Rorke in trying to estimate this time frame. The AR is supposed to be an objective account of what is seen by the medical examiner. But a noted observation can be misleadingly assumed to be an impartial conclusion. For instance, Meyer noted the following information:
The 1450 gm brain has a normal overall architecture. Mild narrowing of the sulci and flattening of the gyri are seen. No inflammation is identified.
A
normal overall architecture is a subjective description. So too is
mild narrowing. But theyre important in knowing that Meyer made a general observation that there was not very much swelling of the brain. But in that same passage he notes that the brain weighed 1450 gm. For comparison on brain weights from another post (
http://www.websleuths.com/forums/sh...ll-Fractures-The-Weapon&p=9054790#post9054790):
Weight of the Human Brain:
The average normal mass of an adult male human brain is approximately 1300 to 1400 grams (2.87 to 3.1 pounds).
The average Male's brain weighs 1360 grams (3 pounds)
The average Female's brain weighs 1250 grams (2.8 pounds)
A newborn human brain is about 350 to 400 grams (0.77 to 0.88 pounds).
A humans brain grows quickly in the first years and reaches its full size by around the age of six.
The brain weights of some well known people:
The brain of Albert Einstein weighed a mere 1230 grams (2.71 pounds)
The brain of the German mathematician Carl Friedrich Gauss weighed 1492 grams (3.29 pounds)
The brain of the leading poet of the Russian Revolution Vladimir Vladimirovich Mayakovsky weighed a whopping 1700 grams (3.75 pounds)
Here are two charts showing average brain weights by age (one is by weight alone, while the other shows it as a ratio to body weight). Ive added a green line showing where a 6 yo female should be on the scale and a red line to indicate JonBenets brain weight as measured during autopsy:
View attachment 58346
Depending on the way it is compared, JonBenets brain at death weighed from 15 to 25 % more than normal for her age -- hardly what most people would call mild swelling of the brain, and an
objective measurement of the extent of edema.
Here is an illustration showing several of the different signs of swelling in a brain (because of copyrights, I should mention it was taken from
Knights Forensic Pathology by Pekka J. Saukko and Bernard Knight):
View attachment 58347
Something important the AR does
not tell us is whether the swelling is
local,
diffuse half-brain, or
diffuse whole-brain. This combined with an objective measurement of the extent of edema would be an indication of how long the edema had been allowed to progress throughout the brain after the initial injury.
But what causes cerebral edema? Its not simply blood engorgement alone as some might think. Excess blood is only one component of the edema. Most of the swelling occurs from fluid buildup
intracellularly as well as e
xtracellularly (inside cells and in the spaces between the cells). One way this fluid can be seen microscopically is in the spaces surrounding and within the brain cells (both
neuronal and
neuroglial). This is possibly the reason for Meyers notation about the
clear halos seen surrounding these cells (although there can be other reasons for this phenomenon). Additionally, as the swelling increases, it constricts the brain vasculature, slowing and then potentially shutting off blood flow
from the brain. As the constricted blood continues building up in the brain, it and the other fluids become self-potentiating in that their excess continues to contribute to more swelling. The ICP (
intracranial pressure) exponentially rises -- perpetuating itself and causing additional bleeding within the skull from any ruptured or open blood vessels.
Swelling on any
external surface of the body (an injured ankle, wrist, etc.) is not limited as it is within the skull where there is little room to allow expansion of the brain other than through the
foramen magnum at the base of the skull. Thats why, as a brain swells, it begins altering the appearance of the outside ridges of the brain -- the
gyri and
sulci. When there is no room left within this small space, the brain begins pressing at the base of the skull through the only opening -- the foramen magnum in the
posterior cranial fossa. This is the opening through which the brain stem goes between the brain and the spinal column. When this stage of edema is reached, the tonsils of the cerebellum are impacted to the point that they become cone-shaped going into the foramen magnum. Ive read about this effect, and Ive seen pictures of normal versus impacted brains. The difference is very subtle and usually hard to notice without careful study. Unless a medical examiner is actually looking for this herniation because of other signs of edema, it might easily go unnoticed. Discoloration of the coned area is another sign, as well as
necrosis of the impacted brain tissue.
Its important to note here that
in children, cerebral edema is more likely, more pronounced, and more quickly occurring than in an adult with the same injury. Also, edema in the brain can be caused from (or worsened by) hypoxia (ischemic hypoxia can be caused by strangulation). IOW, (and this is very important)
strangulation increases brain swelling beyond what would be expected simply from a TBI (
traumatic brain injury)
alone.
Most of all this information Ive written about here is not information we have available to us about the conditions of JonBenets brain. We know simply what little was written in the AR. It is therefore difficult trying to second-guess the opinion of a pathologist who has seen evidence we havent; and I dont doubt that Dr. Rorke is as qualified as any other neuropathologist to estimate the length of time between a head injury and the death of a victim. But even with all the knowledge she or anyone else might have, there are limits to how accurate any estimate can be. Ive written here about just some of the variables that can affect an estimate. Did she take into account the fact that a childs cerebral edema develops much faster than an adults? Did she consider only how long it would take for the brain injury to develop separately to the point it did before the cord was wrapped around her neck ending her life? Or did she even consider the effect that strangulation would have on brain swelling if it was being applied at the same time as the blunt force trauma? I dont doubt her expertise in the field of brain trauma, but how much does she know about the effects of strangulation? What were the assumptions she made (and she
had to make assumptions) when arriving at her estimate? All we know is that resulting 45 to 120 minute timeframe she gave authorities. In one interview, Kolar mentions that she had also considered the digested pineapple in arriving at her opinion -- in addition to the cerebral edema and the necrosis of brain tissue.
But back to the original question:
If the head blow was inflicted prior to (45 minutes-2 hours, according to Kolar?) strangulation, then why was there no evidence of inflammatory infiltrate or organization of the hemorrhage? Perhaps the simple answer to that question is that the supposition of 45 minutes to 2 hours is incorrect. In my opinion those things should have manifest themselves within a much shorter timeframe. Between the three conflicting injury responses (edema, inflammatory infiltrate, and organization of the hemorrhage), I believe the edema to be the least accurate measurement because of all the variables affecting it. But there are also other problems with that longer timeframe that Ill try to address in another post.
Some of this information comes from another post I wrote at FFJ which has additional information on causes and types of cerebral edema. That post is here:
http://www.forumsforjustice.org/for...kull-Fractures-The-Weapon&p=194988#post194988
Another post that addresses blood flow to the brain and some of the statements by Dr. Wecht:
http://www.websleuths.com/forums/showthread.php?7469-John-Ramsey-s-Role/page8&p=9570391#post9570391
ullhair:, and then you post an entire article on that idiot Spitz. Nevermind. I'll just go back to sleep. :sleep:
