Is cerebral swelling following cranio-cerebral trauma instantaneous? An insight into the Byard and Vink proposition

Excerpt

A 56-year old male was hit by a train while he was attempting to cross the tracks. The body was found next to the railway tracks with the dismembered right arm lying to the left. The cranium was open and brain fragments were scattered around the head of the deceased (Fig. 1a). Apart from a large open wound on the head and face, and dismemberment of the right arm, external observations at autopsy included abrasions measuring 17 × 3 cm on the lateral aspect of the right side of his chest, and 18 × 2 cm on the antero-lateral aspect of the right thigh. A superficial laceration measuring 10 × 3 cm was present on the lateral aspect of the upper half of the right thigh. Multiple fractures of the vault and base of skull, facial bones, and lower jaw were observed. Examination of the half of the brain that was lying outside the skull revealed gyral flattening, especially in the frontal and occipital regions, suggestive of cerebral swelling (Fig. 1b). All other internal organs were macroscopically unremarkable.

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