Two vehicles collided in an intersection. Vehicle 2 collided with Vehicle 1 on the passenger side. A male passenger (front seat) in Vehicle 1 was ejected from the car and found deceased face down. The cause of death was from head injury sustained in a motor vehicle incident. The widespread nature of the injuries is associated with the impact point of the collision being to the door of the passenger side of the vehicle where the individual was sitting. Cabin intrusion and disruption contributed to the direct impact forces to the body and would have been associated with the individual being ejected from the vehicle.
Fig.1 Anterior view showing the splitting laceration of the right side of the head.
Fig.2 Anterior view showing the somewhat patterned, abraded injuries on the right upper and lower chest. Note the altered form of the left forearm is indicative of a fracture.
There were multiple fractures of the calvarium and facial skeleton associated with a laceration that extended from the nose anteriorly through the right eyelid over the vertex of the head to the occiput (Fig.1). Much of the brain had been ejected from the head and was received separately from the deceased’s body. There were abrasions on the right upper and lower chest and the left flank (Fig.2). The sternum showed a transverse fracture. The right 1st to 6th ribs showed fractures at the costovertebral junctions and the left 3rd to 5th ribs were fractured anteriorly.
The left forearm was fractured, and there were multiple abrasions over the dorsal aspect of the left and right hands and wrists (see Fig.2). There was a parchment-like abraded injury on the right upper lateral thigh and multiple abrasions over the anterior aspect of the right lower leg and anterior and lateral aspects of the right ankle. There was a transverse laceration measuring 80 mm (3.14″) on the left lower leg with bone visible. There was a fractured pelvis. The left pleural cavity contained 200 mL of blood (6.7 fl oz), and the right pleural cavity contained 150 mL of blood (5 fl oz).
Fig.3 Postmortem CT showed a severe skull fracture with evisceration of the brain.
Fig.4 VR images of the six standard views of the skull showing extensive fragmentation of the entire skull.
Postmortem CT showed a severe skull fracture with evisceration of the brain (Fig.4). The right orbit was disrupted, but the globe was intact, sitting free in the bone debris (Fig.5). There was a large left hemothorax and multiple fractured ribs, including the right 1st to 6th ribs, which were fractured at the costovertebral junctions (Fig.6). The pelvis was grossly disrupted with a central fracture-dislocation of the left hip joint, bilateral pubic rami fractures, and fractures traversing the midbody of the sacrum and both sacral ala (Fig.7). The transverse processes of the 5th lumbar vertebra were disrupted. There was also a transverse fracture of the anterior cortex of the inferior sternal body (Fig.8).
Fig.5 Axial reconstruction of the head showing the intact right globe (white arrow) sitting free within the bone debris of the heavily fractured right orbit.
Fig.6 Coronal MPR showing the fractures of the costovertebral junctions of right 1st to 6th ribs.
Fig.7 VR image of the anterior pelvis showing fracture–dislocation of the left hip joint, bilateral pubic rami fractures, and fractures traversing the midbody of the sacrum and both the sacral ala.
Fig.8 Coronal reconstruction of the sternum showing a transverse fracture of the anterior cortex of the inferior sternal body.
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