Head injury vs. strangulation ***WARNING! AUTOPSY PHOTOS!***

[boro]

Hello all,

I'm new and have a few insights to share. I'm sorry to dredge up an old thread, but I'm unable to put all my thoughts in one place due to insufficient posting privileges, so I'm finding appropriate threads to add my reply to.

I haven't had a chance to read all the replies in this thread (I did read the first one though) but I will soon. I do notice that a lot of you are going into more detain about certain injuries than I will, but I'd like to share my insights into her head injury with relation to my medical studies and experiences with head trauma.

Basically, I'd like to submit that it is of my opinion that little JonBenet was upright and conscious when she was struck in the head by the flashlight (which forensically matches the wound according to the Bonita Papers and the expert in the first post of this thread). I'd also like to submit that she died VERY soon after the head blow.

Several days ago I thoroughly reviewed the autopsy report in this area as well as the photos. It looks to me that she was strangled at least twice, possibly three times (due to the different line marks on her neck) but I can't say anything conclusively regarding that.

However, after reviewing the photos and the description of her injuries, I believe that she was upright and conscious when struck. The blow to her head came in a mostly downward direction but slightly to the right also (when facing the front of JonBenet). The nature of her injuries and the weapon used suggests that the killer was facing JonBenet face to face when she was struck.

My reasoning is the bruising to her brain, and the damage to her skull. The crown of the flashlight is, to my understanding, what caused her skull to cave in rather than crack in that one location on the top of her head. The contusion on her brain extends forward along the fracture from this location, meaning that something had to strike her head ahead of this point as well. Thus the killer was very likely facing her, holding the base of the flashlight in hand, when he or she struck JonBenet.

She was upright and conscious, and struck slightly to the right (facing JonBenet), because of the coup/contrecoup injuries to the temporal lobes of her brain. The right temporal lobe has a much more distinct contusion suggesting the initial direction of travel was to the left. Once her head stopped moving, her brain hit the opposing side of her skull with less force resulting in a smaller contrecoup injury.

However, the nature of the contusions (and the relative lack of contusions along the side, rather than the top of her brain) suggests that she was struck very much in a downward direction with only a slight cant to the right (facing JonBenet). This suggests that JonBenet must have been upright and conscious when struck, as any resistance to head movement (such as her lying unconscious or dead on the floor) would have prevented any coup/contrecoup injuries from taking place from this relatively minor force to the right (compared to the extreme downward force from the blow).

Beyond the above, JonBenet was clearly alive when she was struck, although not for long. Her contusions and hemorrhaging suggest that she was alive for a few minutes after the blow, but for no more than a few minutes. This conclusion is taken from the following observations on the autopsy report:

After reflecting the scalp, the coroner found the underlying hemorrhage and noted it was fresh and had no evidence of organization. This means the wound had not yet begun to coagulate in any form. Wounds, even devastating head injuries which tend to bleed rather profusely, begin coagulating fairly quickly after their creation.

While there was hemorrhage present, there wasn't a significant enough amount to suggest she had been alive for more than a few minutes after the injury. Again, head injuries tend to bleed profusely.

No external evidence of scalp injury was present. Girls bruise easier than boys. Children bruise more easily than adults. JonBenet would have begun to show evidence of a large contusion around the wound if she had been alive for long afterwards.

No inflammation was identified. Her brain had not yet begun to swell from the injury.

There is no evidence of inflammatory infiltrate. These are white blood cells that enter and begin to repair damaged (inflamed) tissue. They arrive fairly quickly, but were not present.

From the above, I surmise that JonBenet was struck from the front, while upright and conscious, and that she survived for no more than a few minutes after the blow. From petechial hemorrhages and other present injuries most of us have already concluded that she was alive when she was strangled and that it was the ultimate cause of death. It's clear that she did not struggle during the strangulation which would coincide with her being struck in the head and unconscious at the time the strangulation occurred.

It is of my opinion that these events were separated by no more than a few minutes, and therefore the killer had to have had the materials necessary to construct the ligature handy (or perhaps it was already made and they already knew they were going to kill her) at the time she was struck.

Super Dave, on what I'll call the other forum you suggested that you had information showing that she could have been alive for up to 45 minutes after the head blow. I don't doubt you as I'm not infallible, but I'd be very interested in seeing how they arrived at this conclusion.
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[BBB167893]

Hello all,

I'm new and have a few insights to share. I'm sorry to dredge up an old thread, but I'm unable to put all my thoughts in one place due to insufficient posting privileges, so I'm finding appropriate threads to add my reply to.

I haven't had a chance to read all the replies in this thread (I did read the first one though) but I will soon. I do notice that a lot of you are going into more detain about certain injuries than I will, but I'd like to share my insights into her head injury with relation to my medical studies and experiences with head trauma.

Basically, I'd like to submit that it is of my opinion that little JonBenet was upright and conscious when she was struck in the head by the flashlight (which forensically matches the wound according to the Bonita Papers and the expert in the first post of this thread). I'd also like to submit that she died VERY soon after the head blow.

Several days ago I thoroughly reviewed the autopsy report in this area as well as the photos. It looks to me that she was strangled at least twice, possibly three times (due to the different line marks on her neck) but I can't say anything conclusively regarding that.

However, after reviewing the photos and the description of her injuries, I believe that she was upright and conscious when struck. The blow to her head came in a mostly downward direction but slightly to the right also (when facing the front of JonBenet). The nature of her injuries and the weapon used suggests that the killer was facing JonBenet face to face when she was struck.

My reasoning is the bruising to her brain, and the damage to her skull. The crown of the flashlight is, to my understanding, what caused her skull to cave in rather than crack in that one location on the top of her head. The contusion on her brain extends forward along the fracture from this location, meaning that something had to strike her head ahead of this point as well. Thus the killer was very likely facing her, holding the base of the flashlight in hand, when he or she struck JonBenet.

She was upright and conscious, and struck slightly to the right (facing JonBenet), because of the coup/contrecoup injuries to the temporal lobes of her brain. The right temporal lobe has a much more distinct contusion suggesting the initial direction of travel was to the left. Once her head stopped moving, her brain hit the opposing side of her skull with less force resulting in a smaller contrecoup injury.

However, the nature of the contusions (and the relative lack of contusions along the side, rather than the top of her brain) suggests that she was struck very much in a downward direction with only a slight cant to the right (facing JonBenet). This suggests that JonBenet must have been upright and conscious when struck, as any resistance to head movement (such as her lying unconscious or dead on the floor) would have prevented any coup/contrecoup injuries from taking place from this relatively minor force to the right (compared to the extreme downward force from the blow).

Beyond the above, JonBenet was clearly alive when she was struck, although not for long. Her contusions and hemorrhaging suggest that she was alive for a few minutes after the blow, but for no more than a few minutes. This conclusion is taken from the following observations on the autopsy report:

After reflecting the scalp, the coroner found the underlying hemorrhage and noted it was fresh and had no evidence of organization. This means the wound had not yet begun to coagulate in any form. Wounds, even devastating head injuries which tend to bleed rather profusely, begin coagulating fairly quickly after their creation.

While there was hemorrhage present, there wasn't a significant enough amount to suggest she had been alive for more than a few minutes after the injury. Again, head injuries tend to bleed profusely.

No external evidence of scalp injury was present. Girls bruise easier than boys. Children bruise more easily than adults. JonBenet would have begun to show evidence of a large contusion around the wound if she had been alive for long afterwards.

No inflammation was identified. Her brain had not yet begun to swell from the injury.

There is no evidence of inflammatory infiltrate. These are white blood cells that enter and begin to repair damaged (inflamed) tissue. They arrive fairly quickly, but were not present.

From the above, I surmise that JonBenet was struck from the front, while upright and conscious, and that she survived for no more than a few minutes after the blow. From petechial hemorrhages and other present injuries most of us have already concluded that she was alive when she was strangled and that it was the ultimate cause of death. It's clear that she did not struggle during the strangulation which would coincide with her being struck in the head and unconscious at the time the strangulation occurred.

It is of my opinion that these events were separated by no more than a few minutes, and therefore the killer had to have had the materials necessary to construct the ligature handy (or perhaps it was already made and they already knew they were going to kill her) at the time she was struck.

Super Dave, on what I'll call the other forum you suggested that you had information showing that she could have been alive for up to 45 minutes after the head blow. I don't doubt you as I'm not infallible, but I'd be very interested in seeing how they arrived at this conclusion.
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You speak my name, and I appear, boro!

Before we do anything else, I think that your post here deserves a standing ovation.

But, my understanding is that they arrived at this conclusion based on a few things that I would quibble with. (I use your statements in italics)

1) After reflecting the scalp, the coroner found the underlying hemorrhage and noted it was fresh and had no evidence of organization. This means the wound had not yet begun to coagulate in any form. Wounds, even devastating head injuries which tend to bleed rather profusely, begin coagulating fairly quickly after their creation.

There seems to a problem among the pathologists. Henry Lee described the head wound as "fully developed" and Werner Spitz and Tom Henry both used the word "clot." I'm not a doctor or a medical student, but I know what "clot" means: coagulation of blood. Now, the coroner said that there was none, and I suppose he'd know best. But Werner Spitz seems to have the most experience with head injuries. A puzzlement!

2) While there was hemorrhage present, there wasn't a significant enough amount to suggest she had been alive for more than a few minutes after the injury. Again, head injuries tend to bleed profusely.

Again, I'm not a medical practitioner, but I know that head wounds are the quirkiest wounds of the body. Some bleed profusely, others hardly at all. The police interviewed a Denver area neurosurgeon, Dr. Kerry Brega. She said that she sees a lot of major head injuries with hardly any bleeding at all, and those people did not get strangled on the way in.

3) No external evidence of scalp injury was present. Girls bruise easier than boys. Children bruise more easily than adults. JonBenet would have begun to show evidence of a large contusion around the wound if she had been alive for long afterwards.

Maybe you could help me out with something. I've long been under the impression that a lot of these issues with the blood and clotting and infiltrate can be accounted for by shock. Is that anywhere near true? Shock causes the body to shut down to a great degree, almost to a suspended state. I've heard of cases where people were thought to be dead because shock had reduced their blood flow and breathing so greatly their pulse and respiration were undetectable. Thus, it might take longer for JB to form bruises.

4) No inflammation was identified. Her brain had not yet begun to swell from the injury.

I have to address this one, boro. I've read the same report you have, and it clearly states "narrowing of the sulci and flattening of the gyri." For those of you laypeople out there, the sulci are the folds in the brain, and the gyri is the brain matter that is folded. What that statement means is, that her brain HAD swollen to the point where it was actually pressing against the skull. And I've always heard that takes time.

Without having them on hand to ask, it's my impression that the pathologists used that criteria. But as I said: these may turn out to be trivial issues. If so, please tell me. You've made a damn fine argument either way.

Folks, we'll have to keep an eye on this young fella!

 

[DeeDee249]

Several forensic pathologists have reviewed the autopsy report and in some cases the photos as well, and there is a general agreement that anywhere up to an hour could have elapsed between the two causes of death. The head bash was described by one doctor as "this is not something that kills her right away". However, it WOULD have rendered her unconscious right away and she may have lapsed into a coma at some point too. Going into shock and/or coma would also have caused her body temperature to drop (so she'd feel cold to the touch) and her breathing and pulse rate to slow to the point where they were imperceptible to an untrained person.

 

[BBB167893]

Several forensic pathologists have reviewed the autopsy report and in some cases the photos as well, and there is a general agreement that anywhere up to an hour could have elapsed between the two causes of death. The head bash was described by one doctor as "this is not something that kills her right away". However, it WOULD have rendered her unconscious right away and she may have lapsed into a coma at some point too. Going into shock and/or coma would also have caused her body temperature to drop (so she'd feel cold to the touch) and her breathing and pulse rate to slow to the point where they were imperceptible to an untrained person.

That's what I'm asking him/her, DD.

 

[boro]

Thanks for the praise, Dave! Let's see if we can figure these issues out.

You speak my name, and I appear, boro!

Before we do anything else, I think that your post here deserves a standing ovation.

But, my understanding is that they arrived at this conclusion based on a few things that I would quibble with. (I use your statements in italics)

1) After reflecting the scalp, the coroner found the underlying hemorrhage and noted it was fresh and had no evidence of organization. This means the wound had not yet begun to coagulate in any form. Wounds, even devastating head injuries which tend to bleed rather profusely, begin coagulating fairly quickly after their creation.

There seems to a problem among the pathologists. Henry Lee described the head wound as "fully developed" and Werner Spitz and Tom Henry both used the word "clot." I'm not a doctor or a medical student, but I know what "clot" means: coagulation of blood. Now, the coroner said that there was none, and I suppose he'd know best. But Werner Spitz seems to have the most experience with head injuries. A puzzlement!

Interesting indeed!

I took a second look at the autopsy report. The coroner mentions hemorrhaging of the brain and head of JonBenet on two separate occasions. On one, regarding the hemorrhaging on the outside of her skull, the coroner notes "This grossly appears to be fresh hemorrhage with no evidence of organization". I can't be positive, but the language suggests an overall impression rather than an in-depth analysis.

However, the second mention is rather specific: "There is no evidence of inflammatory infiltrate or organization of the hemorrhage". Curious.

Coagulation is an excellent way of arriving at a short-term timeline for a wound, particularly one of this size.

One has to consider the complexity of the head and brain itself. A coroner is very much like a general practitioner...they know a little about everything but may not be an expert at any one particular area of the body.

I'm not familiar with the people you mentioned, but if a head trauma expert saw signs that the injury was coagulating, I'd tend to listen!

2) While there was hemorrhage present, there wasn't a significant enough amount to suggest she had been alive for more than a few minutes after the injury. Again, head injuries tend to bleed profusely.

Again, I'm not a medical practitioner, but I know that head wounds are the quirkiest wounds of the body. Some bleed profusely, others hardly at all. The police interviewed a Denver area neurosurgeon, Dr. Kerry Brega. She said that she sees a lot of major head injuries with hardly any bleeding at all, and those people did not get strangled on the way in.

Interesting, and something I haven't come across yet. I was basing my findings on my previous experiences with head trauma, all of which were profuse bleeders. But I would never claim to have as much experience in this area as Dr. Brega.

3) No external evidence of scalp injury was present. Girls bruise easier than boys. Children bruise more easily than adults. JonBenet would have begun to show evidence of a large contusion around the wound if she had been alive for long afterwards.

Maybe you could help me out with something. I've long been under the impression that a lot of these issues with the blood and clotting and infiltrate can be accounted for by shock. Is that anywhere near true? Shock causes the body to shut down to a great degree, almost to a suspended state. I've heard of cases where people were thought to be dead because shock had reduced their blood flow and breathing so greatly their pulse and respiration were undetectable. Thus, it might take longer for JB to form bruises.

The bruising was a bit of an outlier. It's entirely possible that without any outside intervention it could have taken up to an hour or more for a bruise to form on JonBenet, but the longer she stayed alive, the greater the chances that the bruise would have shown up post-mortem and would have been obvious to the coroner.

You raise an excellent point about shock being a cause of reduced hemorrhaging (and the resultant bruising), however, generally reduced blood flow shouldn't negatively affect clotting, nor should it affect the delivery of infiltrate as both agents are (or should be) spread consistently throughout the bloodstream and stand a greater chance of attaching to the wound surface when flow is reduced. The connection of slow blood flow and increased clotting can often be observed in the elderly and others with lower than normal blood flow.

But, it is entirely possible that JonBenet suffered neurogenic shock after the blow and may have appeared to be dead or nearly dead. I'll have to take another look at her injuries to see if this was the case.

4) No inflammation was identified. Her brain had not yet begun to swell from the injury.

I have to address this one, boro. I've read the same report you have, and it clearly states "narrowing of the sulci and flattening of the gyri." For those of you laypeople out there, the sulci are the folds in the brain, and the gyri is the brain matter that is folded. What that statement means is, that her brain HAD swollen to the point where it was actually pressing against the skull. And I've always heard that takes time.

Without having them on hand to ask, it's my impression that the pathologists used that criteria. But as I said: these may turn out to be trivial issues. If so, please tell me. You've made a damn fine argument either way.

Thanks for the praise again!

I apparently glossed over that in favor of the "no inflammation was identified" immediately following.

I have to admit I'm more familiar with working with the living rather than the dead. Did the brain become inflamed during life but then reduce in size after death? I have to admit I don't know. But it's worth looking into.

Brain inflammation does take time to develop, and even mild inflammation as suggested in the autopsy could suggest an extended time period after the blow.

I'm curious about the contradicting reports about the hemorrhaging. That alone could provide a clear timeline one way or another. Unfortunately, everyone is different so it would be impossible to say just HOW long. But if clotting was present the timeline could be easily extended beyond just a few minutes.

That leaves the mystery of the infiltrate but I'm less well versed on the exact workings of those cells than I am on other components of the head injury. I'll need to look into it more.

I'll have to check on that and the neurogenic shock and post back!
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[BBB167893]

Thanks for the praise, Dave! Let's see if we can figure these issues out.

Interesting indeed!

I took a second look at the autopsy report. The coroner mentions hemorrhaging of the brain and head of JonBenet on two separate occasions. On one, regarding the hemorrhaging on the outside of her skull, the coroner notes "This grossly appears to be fresh hemorrhage with no evidence of organization". I can't be positive, but the language suggests an overall impression rather than an in-depth analysis.

However, the second mention is rather specific: "There is no evidence of inflammatory infiltrate or organization of the hemorrhage". Curious.

Coagulation is an excellent way of arriving at a short-term timeline for a wound, particularly one of this size.

One has to consider the complexity of the head and brain itself. A coroner is very much like a general practitioner...they know a little about everything but may not be an expert at any one particular area of the body.

I'm not familiar with the people you mentioned, but if a head trauma expert saw signs that the injury was coagulating, I'd tend to listen!


Interesting, and something I haven't come across yet. I was basing my findings on my previous experiences with head trauma, all of which were profuse bleeders. But I would never claim to have as much experience in this area as Dr. Brega.


The bruising was a bit of an outlier. It's entirely possible that without any outside intervention it could have taken up to an hour or more for a bruise to form on JonBenet, but the longer she stayed alive, the greater the chances that the bruise would have shown up post-mortem and would have been obvious to the coroner.

You raise an excellent point about shock being a cause of reduced hemorrhaging (and the resultant bruising), however, generally reduced blood flow shouldn't negatively affect clotting, nor should it affect the delivery of infiltrate as both agents are (or should be) spread consistently throughout the bloodstream and stand a greater chance of attaching to the wound surface when flow is reduced. The connection of slow blood flow and increased clotting can often be observed in the elderly and others with lower than normal blood flow.

But, it is entirely possible that JonBenet suffered neurogenic shock after the blow and may have appeared to be dead or nearly dead. I'll have to take another look at her injuries to see if this was the case.



Thanks for the praise again!

I apparently glossed over that in favor of the "no inflammation was identified" immediately following.

I have to admit I'm more familiar with working with the living rather than the dead. Did the brain become inflamed during life but then reduce in size after death? I have to admit I don't know. But it's worth looking into.

Brain inflammation does take time to develop, and even mild inflammation as suggested in the autopsy could suggest an extended time period after the blow.

I'm curious about the contradicting reports about the hemorrhaging. That alone could provide a clear timeline one way or another. Unfortunately, everyone is different so it would be impossible to say just HOW long. But if clotting was present the timeline could be easily extended beyond just a few minutes.

That leaves the mystery of the infiltrate but I'm less well versed on the exact workings of those cells than I am on other components of the head injury. I'll need to look into it more.

I'll have to check on that and the neurogenic shock and post back!
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Sounds like we'll be at this for a while.

One thing I don't dispute: JB would have been standing when hit. An adult-sized person would have the leverage necessary to deliver that devastating blow with an overhand swing.

 

[boro]

I've reviewed the injuries and I can't find anything conclusive to say that JonBenet would have suffered neurogenic shock or not. It's certainly possible, and she almost certainly would have been rendered unconscious.

If she did suffer neurogenic shock, it could explain the lack of inflammation present. But the lack of infiltrate is still curious.

I think the key here is determining whether or not the wound had actually begun to clot, or not.

IF clots were present (depending on the number and significance), but no other outward sign of injury as mentioned in the autopsy, then there could have realistically been up to an hour separating the blow from her death.

If, as the words of the coroner would suggest, there were NO clots present at all, then I don't think she would have had more than 5 minutes between the blow and her death.

I'm looking more into finding an accurate timeline regarding the introduction of white blood cells after a traumatic brain injury. I'll hopefully have something to report on that in a moment.
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[DeeDee249]

The bruising found in areas of her brain could be attributed to someone shaking her- the brain hits the inside of the skull in a kind of "shaken-baby" syndrome. I can certainly envision someone shaking her hard in an attempt to bring her around.
The flattening and narrowing of the sulci and gyri are indicative of swelling of he brain, but the coroner described this as mild. I doubt the swelling was worse in life and receded after death, but rather the swelling was mild because death occurred before more swelling could occur.

 

[boro]

I need to start taking my ADD pills again!

I went through the autopsy once more and I take back what I said. JonBenet Ramsey DOES show possible signs that she entered into neurogenic shock after the blow was delivered.

The coroner notes that there is perhaps mild congestion at the cortex of her kidneys.

This is a symptom that accompanies a condition known as ischemia, or the failure of an organ due to reduced blood supply. Kidneys are among the first organs to become ischemic in a situation such as this, when shock has dramatically reduced blood flow.

It doesn't help establish a timeline yet, but it does provide evidence that JonBenet had entered neurogenic shock and that her organ(s) were showing early signs of failure due to the reduced blood supply. As the coroners and others stated, the head injury would have certainly killed her if the strangulation didn't.

I still need more time to study the effects of severe neurogenic shock and bradycardia on infiltrate and coagulate delivery.

From what I understand now however, the neutrophils, or early responding inflammatory infiltrates, should have been on the site within minutes and would have accompanied any swelling of the brain. However they were not present.

Regarding SBS, it's possible but the nature of the contusions suggests a single uneven blow rather than a repeated shaking injury.
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[boro]

Well, last post of the night.

Anyway, here's what I can conclude:

IF the state of neurogenic shock that JonBenet was in was severe enough to severely reduce blood flow, it would have a compounding effect on the autopsy findings:

The overall amount of hemorrhaging would be reduced.
The rate of renal failure due to ischemia would be increased.
The rate of clotting would be increased.

At this point I was confused. If JonBenet had been in a severe state of bradycardia and ischemia long enough to begin showing signs of renal failure, why was the accumulation of neutrophils not taking place at the site of the injury to her her head (and others, as evidenced by the autopsy report)?

I've read several medical studies pertaining to neutrophil recruitment in ischemic brain tissue and I believe I found the key to solving the mystery behind this question. A study on neutrophil recruitment in ischemic brain tissue in stroke victims was performed to determine the role of the inflammatory infiltrates in the recovery proces.

Neutrophils appear early in regions of ischemic cerebral hemisphere defined structurally by coregistration of SPECT images and CT, and may be present from as early as 19 hours.

http://stroke.ahajournals.org/content/35/7/1659.long

"As early as 19 hours", which suggests, in a state of severe ischemia, inflammatory infiltrates may not be expected to arrive until that time.

Thus I can conclude that, if JonBenet was in a state of neurogenic shock severe enough to very nearly halt her autonomic functions (as the evidence of early renal failure as well as the condition of her pulmonary arteries due to ischemia that I discovered a few moments ago suggests), then it's easy enough to explain why these infiltrates weren't present during the analysis.

I can conclude however that without the presence of neutrophils, her brain did not swell from the injury. This can be explained by the state of ischemia caused by shock.

Ischemia due to shock could also explain the reduced hemorrhaging, as I mentioned earlier.

The only remaining key to establishing an accurate timeline is whether or not coagulation was present, and if so, how much?

IF it was present then some time could have passed between the blow and her death. How much exactly is a delicate balancing act between the amount of coagulation, the severity of the ischemia due to shock, the advancement of renal failure due to ischemia (which as we know was in it's initial stages at furthest), and the total lack of neutrophils at the location of the brain injury. Each will affect time in one way or another.

I've learned a lot about neutrophils tonight! I'm sure that will be useful at one point or another.
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[BBB167893]

Well, last post of the night.

Anyway, here's what I can conclude:

IF the state of neurogenic shock that JonBenet was in was severe enough to severely reduce blood flow, it would have a compounding effect on the autopsy findings:

The overall amount of hemorrhaging would be reduced.
The rate of renal failure due to ischemia would be increased.
The rate of clotting would be increased.

At this point I was confused. If JonBenet had been in a severe state of bradycardia and ischemia long enough to begin showing signs of renal failure, why was the accumulation of neutrophils not taking place at the site of the injury to her her head (and others, as evidenced by the autopsy report)?

I've read several medical studies pertaining to neutrophil recruitment in ischemic brain tissue and I believe I found the key to solving the mystery behind this question. A study on neutrophil recruitment in ischemic brain tissue in stroke victims was performed to determine the role of the inflammatory infiltrates in the recovery proces.



http://stroke.ahajournals.org/content/35/7/1659.long

"As early as 19 hours", which suggests, in a state of severe ischemia, inflammatory infiltrates may not be expected to arrive until that time.

Thus I can conclude that, if JonBenet was in a state of neurogenic shock severe enough to very nearly halt her autonomic functions (as the evidence of early renal failure as well as the condition of her pulmonary arteries due to ischemia that I discovered a few moments ago suggests), then it's easy enough to explain why these infiltrates weren't present during the analysis.

I can conclude however that without the presence of neutrophils, her brain did not swell from the injury. This can be explained by the state of ischemia caused by shock.

Ischemia due to shock could also explain the reduced hemorrhaging, as I mentioned earlier.

The only remaining key to establishing an accurate timeline is whether or not coagulation was present, and if so, how much?

IF it was present then some time could have passed between the blow and her death. How much exactly is a delicate balancing act between the amount of coagulation, the severity of the ischemia due to shock, the advancement of renal failure due to ischemia (which as we know was in it's initial stages at furthest), and the total lack of neutrophils at the location of the brain injury. Each will affect time in one way or another.

I've learned a lot about neutrophils tonight! I'm sure that will be useful at one point or another.
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We're cookin' now!

I don't know to what degree coagulation was present. The specialists have never stated that publically, provided that they even know.

 

[DeeDee249]

The human body is predictable, but not fool-proof. Things do not always develop or proceed according to the book. There are so many loose ends in this case, so many ifs and buts. In this case, the head bash/skull fracture is compounded by the ligature strangulation, which could have put pressure on the vagus nerve and stopped her heart on its own. We know she was alive because there were petechiae as well as the ligature furrow being red. There is one mark that I notice on her neck that is white, however, and I often wonder if it was made after her death during the blanching (non-fixed) stage of livor mortis. That would mean that the ligature was pulled UNTIL she died, and wound around one more time after that. Was she already dying from the head bash? Maybe- if the head bash came first. This is my theory- because I cannot think of ANY reason (even in a staged crime) to bash her after she was already unconscious or dead, and because I feel the head bash was originally inflicted to shut her up because she screamed. IMO, the head bash came first. The timeline is this (to me) - sexual assault, scream, head bash. The odd piece out is the ligature strangulation. If pure staging, the ligature comes last. If part of the sexual assault, the ligature comes before the head bash. With a garrote pulled that tight, she couldn't scream, so I feel the scream came in reaction to whatever was put in her vagina to cause the bleeding and injuries.

 

[anne11]

Would it be possible that the ligature restricted the inflammatory response in the brain?

 

[UKGuy]

The human body is predictable, but not fool-proof. Things do not always develop or proceed according to the book. There are so many loose ends in this case, so many ifs and buts. In this case, the head bash/skull fracture is compounded by the ligature strangulation, which could have put pressure on the vagus nerve and stopped her heart on its own. We know she was alive because there were petechiae as well as the ligature furrow being red. There is one mark that I notice on her neck that is white, however, and I often wonder if it was made after her death during the blanching (non-fixed) stage of livor mortis. That would mean that the ligature was pulled UNTIL she died, and wound around one more time after that. Was she already dying from the head bash? Maybe- if the head bash came first. This is my theory- because I cannot think of ANY reason (even in a staged crime) to bash her after she was already unconscious or dead, and because I feel the head bash was originally inflicted to shut her up because she screamed. IMO, the head bash came first. The timeline is this (to me) - sexual assault, scream, head bash. The odd piece out is the ligature strangulation. If pure staging, the ligature comes last. If part of the sexual assault, the ligature comes before the head bash. With a garrote pulled that tight, she couldn't scream, so I feel the scream came in reaction to whatever was put in her vagina to cause the bleeding and injuries.

DeeDee249,
Well IMO two things allow you to work out what might have taken place. The sexual assault and the staging.

That is one presumably occurs prior to the other. I assume the sexual assault happened first. And the staging last.

But if you think like the fish and not the fisher-person, then a head bash may indeed have been inflicted in the wine-cellar, all part of the crime-scene as imagined by some Ramsey?

The ligature cannot be part of the sexual assault since no Ramsey would require a ligature to engender an assault. Also as constructed it would not function as any kind of a Erotic Asphxiation device. The latter is a nice theory dreamt up by people who have books to sell.

With a garrote pulled that tight, she couldn't scream, so I feel the scream came in reaction to whatever was put in her vagina to cause the bleeding and injuries.

So does BPD have the offending item in their evidence cage?

The timeline is this (to me) - sexual assault, scream, head bash.

There are many potential timelines and they all begin with a sexual assault. Something I reckon JonBenet was accustomed too, so I reckon the head bash was an accident, not unless someone took the decision to deliberately kill JonBenet.

What is interesting is that the forensic evidence suggests both John and Patsy Ramsey collaborated in the staging. From this you can infer that both were aware that JonBenet was being sexually molested. This then allows other scenarios to be imagined?


.

 

[BBB167893]

Does anybody know where boro went? This was getting really interesting!

 

[azwriter]

DeeDee249,
Well IMO two things allow you to work out what might have taken place. The sexual assault and the staging.

That is one presumably occurs prior to the other. I assume the sexual assault happened first. And the staging last.

But if you think like the fish and not the fisher-person, then a head bash may indeed have been inflicted in the wine-cellar, all part of the crime-scene as imagined by some Ramsey?

The ligature cannot be part of the sexual assault since no Ramsey would require a ligature to engender an assault. Also as constructed it would not function as any kind of a Erotic Asphxiation device. The latter is a nice theory dreamt up by people who have books to sell.



So does BPD have the offending item in their evidence cage?


There are many potential timelines and they all begin with a sexual assault. Something I reckon JonBenet was accustomed too, so I reckon the head bash was an accident, not unless someone took the decision to deliberately kill JonBenet.

What is interesting is that the forensic evidence suggests both John and Patsy Ramsey collaborated in the staging. From this you can infer that both were aware that JonBenet was being sexually molested. This then allows other scenarios to be imagined?


.

Everytime I sign on to WS, I visit this thread. And, this case is as old as some cheese I have in the refrigerator. But, I check in whenever I can.
Dee Dee, I appreciate your posts very much.

In this post, I especially am glad to see you bring up the idea the "professional" garrot does not play into a sexual attack on JonBenet. I've never understood how it came to be a reason it was around her neck. That tatic, as I understand it is something done by a person to themselves when they are alone. Not on another person to gain sexual satisifaction. Certainly a 6-year-old wasn't performing that particular sexual game on herself.

I rarely post on this case anymore. But one thing I do believe is that no one in the family had to fashion the ligature found on her neck. I think it was something already around the Ramsey home. And further, I think it was something Burke had made beforehand to tow things or play with, not in a sexual way.( I recall as a child my sis and I had one we attached to our sled or a wagon.)
IMO it became the perfect tool for the parents to use in the staging.

I have always felt the death scene had to be so outrageous and out of this world horrible in order to take the death of JonBenet far away from the relm that it might have been the parents responsible for her death.

The idea was to make it look absolutely unbelievable that a parent could do this to a child, even in staging a crime scene. And, I have seen posts here where people have commented that they can't believe a parent could carry off a strangling of their own daughter in this manner. So, that tatic works doesn't it. Make it so ugly. So vile, that no one will ever associate it with loving parents who have never been expected of child abuse.

Like I said, I rarely post on this thread anymore. But it felt good to write this tonight. Just wait till I come out of my shell again and explain how I know Patsy wrote the ransom "letter."
just my O

 

[UKGuy]

Everytime I sign on to WS, I visit this thread. And, this case is as old as some cheese I have in the refrigerator. But, I check in whenever I can.
Dee Dee, I appreciate your posts very much.

In this post, I especially am glad to see you bring up the idea the "professional" garrot does not play into a sexual attack on JonBenet. I've never understood how it came to be a reason it was around her neck. That tatic, as I understand it is something done by a person to themselves when they are alone. Not on another person to gain sexual satisifaction. Certainly a 6-year-old wasn't performing that particular sexual game on herself.

I rarely post on this case anymore. But one thing I do believe is that no one in the family had to fashion the ligature found on her neck. I think it was something already around the Ramsey home. And further, I think it was something Burke had made beforehand to tow things or play with, not in a sexual way.( I recall as a child my sis and I had one we attached to our sled or a wagon.)
IMO it became the perfect tool for the parents to use in the staging.

I have always felt the death scene had to be so outrageous and out of this world horrible in order to take the death of JonBenet far away from the relm that it might have been the parents responsible for her death.

The idea was to make it look absolutely unbelievable that a parent could do this to a child, even in staging a crime scene. And, I have seen posts here where people have commented that they can't believe a parent could carry off a strangling of their own daughter in this manner. So, that tatic works doesn't it. Make it so ugly. So vile, that no one will ever associate it with loving parents who have never been expected of child abuse.

Like I said, I rarely post on this thread anymore. But it felt good to write this tonight. Just wait till I come out of my shell again and explain how I know Patsy wrote the ransom "letter."
just my O

azwriter,
Your contributions are always appreciated. The Garrote topic is a well trodden path, but everything benefits from a review.

I've never understood how it came to be a reason it was around her neck.

This was a Lou Smit offering taken up avidly by the media and a few authors looking for meat and mystery to spice up their books on the JonBenet homicide. There is the suggestion that when John Ramsey and Lou Smit were undertaking their prayer conventions, John Ramsey may have impressed upon Lou Smit his Pedophile Intruder theory?

There are two forms of the use of this alleged device, one is AEA, e.g. Auto Erotic Asphyxiation or solo, and EA, e.g. Erotic Asphyxiation or one person on another.

A recent example of AEA is David Carradine who was found hanging by a rope naked in a Bangkok hotel room's closet. This type of fetish is predominately a male prediliction.

JonBenet was 6 years old, so EA cannot apply since she could never give consent or understand what was happening. Its use would represent applied torture in the case of JonBenet.

If you examine the garrote carefully it soon becomes apparent that it could never function as an EA device, not least since a loosening mechanism is absent, as the knotting is tight. Also because if twisted JonBenet's hairs would have been pulled out at her roots, they were not. Evidently it is staging, but not staging to explain away a cause of death, but more likely to hide a prior injury?

Why should this be, because any rational staging would attempt to leverage the evidence such that the intruder gets the blame. Here the garrote fails to do that, in fact it shines a spotlight onto Patsy, since her fibers are embedded into the garrot knotting.

The idea was to make it look absolutely unbelievable that a parent could do this to a child, even in staging a crime scene. And, I have seen posts here where people have commented that they can't believe a parent could carry off a strangling of their own daughter in this manner. So, that tatic works doesn't it. Make it so ugly. So vile, that no one will ever associate it with loving parents who have never been expected of child abuse.

It appears to me as if JonBenet's death was staged incrementally. One of those increments was the addition of the garrote. The question is was it staging to effect a fake cause of death, or staging to mask a prior injury?

Now many assume it cannot be the former since they consider the garrote as the cause of death. And some assume the latter since the garrote is redundant both in functional and staging terms.

What should be considered is that JonBenet may have been deliberately asphyxiated then the garrote was applied, with the stager thinking, the garrote will mask everything?

We know there was no grand staging plan because the R's messed up so spectacularly e.g. size-12's or the pineapple snack!

I look forward to your next post ...


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[Whaleshark]

Not just Lou Smit, though, on the speculation of the garrote being used as an EA device - it Was Cyril Wecht's (forensic pathologist) theory:

"In his book Who Killed JonBenet Ramsey?, he argues that the death was likely an accidental result of a sex “game” committed by her father".
(from wikipedia)

...just saying.

 

[DeeDee249]

I recall something I saw long ago in one of Patsy's interviews. She was talking about BR and saying he always had ropes around "always trying to make a boat or something" were her EXACT words. BR was always tying knots, playing with ropes, etc. And lets not forget he owned a Swiss Army Knife (found in the basement).

 

[UKGuy]

Not just Lou Smit, though, on the speculation of the garrote being used as an EA device - it Was Cyril Wecht's (forensic pathologist) theory:

"In his book Who Killed JonBenet Ramsey?, he argues that the death was likely an accidental result of a sex “game” committed by her father".
(from wikipedia)

...just saying.

Whaleshark,
Yes, he is one of those authors. Many people buy his theory and think EA was applied to JonBenet.

I do not.


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