Thank you. That is informative.
So would you say, given the skull breaks and the "extensive scalp hemorrhage" and the "subarachnoid hemorrhage overlying the entire right cerebral hemisphere", the chances of a bleed from her ear are unlikely, or impossible?
Because that brown-tan stain had to come from somewhere, and there is no evidence of it coming from her nose or mouth. Given that her arm was up next to her ear, I'd say the most likely place it came from was her ear. If it is a medical impossibility I will accept it was not from her ear.
You're welcome.. always glad when I can help.
I think the stain did come from her nose (or maybe mouth). From the AR:
"the upper anterior right sleeve contains a dried brown-tan stainmeasuring 2.5×1.5 inches, consistent with mucous from the nose or mouth"
It's a lot easier to get your nose on the anterior (front) surface of your sleeve than it is your ear. And if it happened as she lay dying as I suspect - on her belly with her arms above and her head towards the right - this would make sense.
I'll never say that something is
impossible. But I'll say that the odds of her having a bleed from her ear are something that I would bet
all my money against. Especially in view of the fact that the ME said, "The external auditory canals are patent and free of blood." The fact that he noted this is significant.
RE: "extensive area of scalp hemorrhage", "subarachnoid hemorrhage and subdural hemorrhage" - the best way I can describe this is to say that these are areas that don't have a direct route to the ear canal. Whereas, when the temporal bone is fractured, it might directly disrupt or cause trauma to the canal (and other nearby anatomy), thereby causing bleeding.
Hoping this will help some:
"Upon reflection of the scalp there is found to be an extensive area ofscalp hemorrhage":
Meyer didn't see anything until he reflected the scalp. All of this hemorrhage was under the scalp.
Subdural hemorrhage
A subdural hematoma (SDH) is a collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane.
Subarachnoid hemorrhage
A bleeding into the subarachnoid, the space between the arachnoid and the pia mater, the innermost membrane surrounding the central nervous system