The Jonbenet Ramsey case is especially interesting on many fronts:
1. Creating a compelling cogent theory of what actually happened ( and secondarily, who did it? }
2. Taking the Jonbenet Ramsey autopsy report and any available photos as baseline data, then using expert opinions from the two opposing camps,i.e. HEAD BLOW FIRST (HBF) vs STRANGULATION FIRST (SF)
A. Cyril Wecht, Dr. Michael Doberson, Adams County Coroner [Strangulation first, Head Blow second theorists]
B. Werner Spitz, Macomb County, MI Medical Examiner, Henry Lee, Ronald Wright, MD, director of the forensic pathology department at the University of Miami School of Medicine, Kerry Brega, chief neurologist at Denver Health Medical Center [Head Blow first, strangulation, second theorists}
3. Reason for and the prosecution of garotte, knot, cord apparatus as part of asphyxiation exercise.
4. Blunt penetration of vagina
5. Paired point skin wounds on low back and right lateral head.
6. Assorted abrasions, ecchymosis, petechiae on the head, neck, face, back, and arms
7. DNA residue on skin and undergarment
8. JBR body pre/post mortem artefacts; cord, makeshift garotte, blanket, pubic hair, blanket particulate matter, footprint, palm print
And for matters of brevity, ignoring for the time being the myriad other issues that are germane to the proper thorough understanding of this unique crime, i.e., ransom note, 911 call, Ramsey behavior, tactics, downstairs artifacts/findings, political social dynamics between Boulder Police, Office of District Attorney, social standing /stratification in Boulder/ analysis of power of City Departments, commercial /professional class, Boulder culture For example, Who Governs Boulder? And How is city community power exercised? Bureaucratic rivalry and conflict. Media practices and influence on crime analysis and adjudication.
Regarding the main question at hand:
I was initially drawn to JBR injuries found at the crime scene and confirmed at autopsy.
In particular I was drawn into this case in the following:
A 6 year old female is found dead in her home.
Attached to her neck was a partially disassembled garotte apparatus consisting of a short wooden stick serving as the fulcrum of a ligature designed to apply sufficient constriction pressure to the mid neck which in turn would eventually occlude the trachea thereby inducing death by asphyxia, anoxic brain death.
Assorted varying shapes of abrasions, contusions, ecchymosis, on neck face hands and torso
Absence of lacerations or penetrating injuries
Striking lack of blood on body, clothes, coverings, blood splatter in basement, hallway, Wine Room, Train Room, stairs, kitchen
Subsequent discovery of large diastastatic depressed right sided skull fracture from frontal bone to occipital bone.i
I am a practicing neuroradiologist with 30 years of experience.
I was recently drawn into this case because of the nature of injuries she sustained; namely a severe head wound, and strangulation neck injury
Consequently, the puzzles arising in this case motivated a deeper inquiry into what was behind this crime.
First areas of interest:
What were the consequences of this large complex skull fracture?
My reading of the autopsy findings maybe faulty; but I found it more than curious that
Striking little scalp swelling due either to hemorrhage or traumatic edema at or around the skull fracture site. Blunt trauma of a force required to cause a lengyhy linea frature combined with a sizeable depressed skull fracture would, I would predict, cause massive scalp swelling. Kerry Bregas (neurologist) comment was perplexing and perhaps highly misleading.
The lack of SIGNIFICANT brain swelling, gyral flattening, deep white matter edema throughout the entire right cerebral hemisphere particularly near the site of depressed parietal skull fracture was dumbfounding.
The relative paucity of blood volume designated subarachnoid hemorrhage, subdural hemorrhage, number and distribution of cortical petechial hemorrhages, the absence of any trace of intra-parenchymal hemorrhage at or near site of depressed parietal skull fracture made absolutely NO SENSE to me. (Note: as a neuroradiologist I analyze both blunt as well as penetrating trauma to brain and skull as a livelihood and have examined thousands such cases) Unlike Brega I have NEVER seen a skull with this sort of fracture constellation WITHOUT SIGNIFICANT soft tissue injury {hemorrhage/edema} to the scalp ( a highly vascular integument that reacts with hemorrhage and swelling goose-egg after the slightest of head bump, assault with a fist, rock, or stick, fender-bender auto accident, not to mention intentional blunt/ penetrating instrument assault with intent to injure.
I have tried in vain to find autopsy photos of scalp related to areas around the fracture meaning photos of head after hair shaved off, close up photos of abrasions contusions lacerations at the site blunt instrument blow(assumed to be the MAG C flashlight).
Spitz recently opined that a massive blow to the head with a MAG flashlight would NOT necessarily cause any scalp injury that would have bleed. Initially, I highly doubt the accuracy of this claim. And will believe it after seeing a confirmed case similar in every way to the Ramsey case.
OR simulating the conditions of this wound on a living subject {prohibited on ethical grounds even if choosing an animal pig, monkey etc)
If the MAG flashlight leading edge did not lacerate, rent the overlying dermis, sufficient force is delivered to underlying soft tissue layers as to incite intense inflammatory changes hemorrhage and edema. The underlying fracture of 2 layers of bone would set up hemorrhage subgaleal hemorrhage, as well as epidural, and or Subdural hemorrhage, which depending on a number of physiological factors could be maybe mild but also marked .
Without delving into the neuropatholigic findings in the settings of high energy blunt trauma, I remain unable to square the theory of head injury first, with its ancillary staged strangulation second.
I am open to a coherent theory of why head blow first, strangulation second- but I would wish to inspect autopsy photos of head.
My interest includes photos of the following:
head shaved of all hair,
head with scalp flap pealed back over fracture site,
cut sections of injured scalp, including microscopy views,
head with scalp removed,
head with skull cap removed,
gross brain in all views,
view of intracranial vault after brain, meninges, brain stem removed,
then cut brain views- including entire right hemisphere AP, lateral, view from top and view from bottom,
then coronal views of brain slabs displayed in order from frontal lobe to occipital lobe.
If someone in this forum can provide commentary germane to the questions I pose above, I welcome a response. If someone could direct me to a website showing JBR autopsy photos that necessarily include photos of the skull, brain,and cut brain specimens, I would be deeply grateful.
Thanks
Zeno49
