A middle-aged male was driving a semi-tractor with an attached trailer in heavy fog. On approaching a sharp left bend in a 60 km/h (37 mph) zone, the trailer tipped and the truck flipped onto its right side. It appeared the vehicle entered the bend at approximately 100 km/h (62 mph). The individual was not wearing a seat belt. The cause of death was the severe head injury sustained in the incident.
Fig.1 Anterior view of the head showing extensive lacerations, comminuted skull, and facial fractures with extrusion of the brain.
Fig.2 Left view of the head showing extensive lacerations, comminuted skull, and facial fractures with extrusion of the brain.
Fig.3 Right view of the head showing extensive lacerations, comminuted skull, and facial fractures with extrusion of the brain.
There was marked disruption of the head with extensive abrasions, lacerations, and comminuted skull and facial fractures with extrusion of the brain. The left ear was completely avulsed (Fig.2). There was no evidence of any upper cervical spinal injury. There were minor abrasions, lacerations, and bruises all over the body. The ribs, pelvis, long bones, and vertebral column were grossly intact without evidence of fracture or deformity. The supporting musculature and soft tissues were normal.
The head trauma mostly likely occurred as a result of contact with the road through the driver’s window and may have involved compressive force between the vehicle and road surface. Postmortem CT showed grossly comminuted and depressed fractures of the skull and facial bones because of an extreme anterior compressive force (Fig.4).
Fig.4 VR images of the six standard views of the skull showing grossly comminuted and depressed fractures of the skull and facial bones due to an extreme anterior compressive force.
Fig.5 Anterior view comparison photograph and VR image.
Fig.6 Left view comparison photograph and VR image.
Fig.7 Right view comparison photograph and VR image.
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