Was Burke Involved? # 4

[kanzz]

Dragging this back up from a few days back, because I've noticed something in the autopsy report that I hadn't noticed before.

I'm having questions about this medical examiner.

He states -

"..lying on her back with her arms extended up over her head. The head was turned to the right"

then further on -

"the upper anterior right sleeve contains a dried brown-tan stain measuring 2.5 x 1.5 inches, consistent with mucous from the nose or mouth."

then further on -

"On the right cheek is a pattern of dried saliva and mucous material which does not appear to be hemorrhagic."



Indeed, we can see the dried saliva and mucous non-hemorrhagic 'drip' on her cheek, in the above photo. So he doesn't question the origin of this large brown-tan stain on the upper sleeve of her shirt, which would have been next to her ear, with her head turned towards her right arm, up around her head.

I'm thinking now, if her ear was oozing blood, did the parents see this, is this what made them think the head blow was fatal. Also, was there bleeding from her ear on the red turtleneck, washed out and dried by the time officers collected evidence, getting on for 24 hours later. Is this why she was put back in the white top, so they could say she had been asleep and not changed after she got home. The red top would be a sure sign she had been awake.

Was this ME competent?

Yes, I think the ME was competent. I think what we're seeing in the other photo is a shadow. The head injury JB sustained would not likely cause bleeding from the ear. Try this photo:

 

[Tortoise]

What if the mucous stain came from her wiping her nose on her sleeve? She was, after all, a little kid and little kids tend to do things like that.

I think the measurements of the stain make that unlikely.

 

[Tortoise]

Yes, I think the ME was competent. I think what we're seeing in the other photo is a shadow. The head injury JB sustained would not likely cause bleeding from the ear. Try this photo:

This source disagrees with what you say

[FONT=&quot]

Bleeding from the ear without any obvious cause may indicate a fractured skull

http://www.headinjury.com/emergency.htm[/FONT]

 

[Tortoise]

I am not getting how a non-hemorrhagic mucous stain on the upper anterior sleeve of the shirt ends up being a blood stain on the pillow in this theory.

The stain on the sleeve was not described as non-hemorrhagic mucous. The drip line on her cheek was.

So in other words, where did the apparently hemorrhaged 'blood' on her sleeve originate from, if it was not evidently from her nose or mouth?

 

[Tortoise]

JonBenet had two blue elastic bands in her hair (as well as a cloth tie).

I wonder if the police found a source in the house for blue elastic bands. Can we assume from the description that these were like office supply elastic bands and not hair bands?

Who puts elastic bands on long hair, even in 1996? Patsy said she did, but I think she would take greater care of JonBenet's hair, elastic tears out and breaks hair and is painful to remove. I'm thinking this was styled deliberately, one on top to hide the skull fracture and one at the back to clear hair from her neck that was getting in the way of the ligature cord.

 

[PositiveLight]

JonBenet had two blue elastic bands in her hair (as well as a cloth tie).

I wonder if the police found a source in the house for blue elastic bands. Can we assume from the description that these were like office supply elastic bands and not hair bands?

Who puts elastic bands on long hair, even in 1996? Patsy said she did, but I think she would take greater care of JonBenet's hair, elastic tears out and breaks hair and is painful to remove. I'm thinking this was styled deliberately, one on top to hide the skull fracture and one at the back to clear hair from her neck that was getting in the way of the ligature cord.

Agreed.
I have very long hair and I wouldn't DARE put an office elastic band in my hair. It would need to be cut out! lol
Plus her hair was bleached which makes it even more fragile.

 

[UKGuy]

JonBenet had two blue elastic bands in her hair (as well as a cloth tie).

I wonder if the police found a source in the house for blue elastic bands. Can we assume from the description that these were like office supply elastic bands and not hair bands?

Who puts elastic bands on long hair, even in 1996? Patsy said she did, but I think she would take greater care of JonBenet's hair, elastic tears out and breaks hair and is painful to remove. I'm thinking this was styled deliberately, one on top to hide the skull fracture and one at the back to clear hair from her neck that was getting in the way of the ligature cord.

Tortoise,
Good observations. I think you are the first to extend the staging to the hair bands.

Not certain about this, but it fits with the rest of the staging.

one on top to hide the skull fracture and one at the back to clear hair from her neck that was getting in the way of the ligature cord.

Yet nobody noticed any head injury until the autopsy, and some of JonBenet's hair was embedded into the knotting forming the ligature.

Someone suggested Patsy dressed JonBenet's hair as she was readied for bed, so it would not be tangled the following morning, making it easier to depart?

.

 

[kanzz]

This source disagrees with what you say[FONT=&amp]
[/FONT]

Bleeding from the ear without any obvious cause may indicate a fractured skull

[FONT=&amp]http://www.headinjury.com/emergency.htm[/FONT]

Yes, what that page says is true and it gives good advice for head injuries that happen at home. Some types of skull fractures may cause bleeding from the ear. It depends upon which bone or area of the skull is fractured. If we see bleeding at the ear canal in head injury, we suspect a fracture of the temporal bone because it sits beside the ear canal.

JB's AR says, "comminuted skull fracture which extends from the right occipital to posteroparietal area forward to the right frontal area across the parietal skull".

So, the page you sourced is more of a generalized statement. And I agree. In the presence of a head injury, if you see bleeding in the ear canal, it could be a fractured skull and you should call 911. But this doesn't actually disagree with what I said; which was, "The head injury JB sustained would not likely cause bleeding from the ear." Her injury just wasn't the type to cause it.

 

[Tortoise]

Yes, what that page says is true and it gives good advice for head injuries that happen at home. Some types of skull fractures may cause bleeding from the ear. It depends upon which bone or area of the skull is fractured. If we see bleeding at the ear canal in head injury, we suspect a fracture of the temporal bone because it sits beside the ear canal.

JB's AR says, "comminuted skull fracture which extends from the right occipital to posteroparietal area forward to the right frontal area across the parietal skull".

So, the page you sourced is more of a generalized statement. And I agree. In the presence of a head injury, if you see bleeding in the ear canal, it could be a fractured skull and you should call 911. But this doesn't actually disagree with what I said; which was, "The head injury JB sustained would not likely cause bleeding from the ear." Her injury just wasn't the type to cause it.

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.

 

[TeaTime]

The stain on the sleeve was not described as non-hemorrhagic mucous. The drip line on her cheek was.

So in other words, where did the apparently hemorrhaged 'blood' on her sleeve originate from, if it was not evidently from her nose or mouth?

It was described as "consistent with mucous".

And still this does not correlate with the alleged blood stain on her pillow.

 

[kanzz]

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

 

[Tortoise]

Thank you kanzz.

Perhaps her face had been wiped.

On a slightly different note, do you think there would have been visible bruising on her forehead if the skull fracture had happened say an hour before she was strangled?

 

[Heymom]

I'm thinking now, if her ear was oozing blood, did the parents see this, is this what made them think the head blow was fatal.

No, bleeding from the ear(s) or nose does not necessarily mean a fatal wound, and a normal parent untrained in the medical field, would not assume that to be the case. My son bled from his right ear after he fractured his skull while skateboarding. He was not unconscious, and I knew this was not a good sign, but it certainly wasn't fatal either.

And yes, his fracture was just above and behind his ear.

 

[Heymom]

Thank you kanzz.

Perhaps her face had been wiped.

On a slightly different note, do you think there would have been visible bruising on her forehead if the skull fracture had happened say an hour before she was strangled?

The strike was on the top REAR of her head, so no bruising to her forehead.

 

[kanzz]

Thank you kanzz.

Perhaps her face had been wiped.

On a slightly different note, do you think there would have been visible bruising on her forehead if the skull fracture had happened say an hour before she was strangled?

That's a really good question. I'm so glad you asked, because it forced me to look at something in the AR I hadn't noticed before.

From the AR: "Upon reflection of the scalp there is found to be an extensive area ofscalp hemorrhage along the right temporoparietal area extending from the orbital ridge, posteriorly all the way to the occipital area." (The orbital ridge is the bony ridge below the eyebrow.)
The scalp hemorrhage indicates bleeding under the scalp, rather than on the scalp. Not the same thing we see in a bruise (hematoma) that we get in our skin. Bruising might been visible at some point, I suppose, but I really can't venture a guess.

But, because I re-read this line in the AR - I am now wondering about other issues, including the timing between the head blow and the ligature strangulation... and one more thing...

This is making me think really hard. I might need some time with this, but I'll give you my initial thoughts anyway. It isn't what I have been thinking prior to now. My gut tells me that this is saying that blood from the blow seeped downward - toward the right temporoparietal area from the orbital ridge and posteriorly all the way to the occipital area - which would mean that her head remained upright for some period of time after that blow.

 

[sek4278]

Are you thinking what I'm thinking? Maybe JB heard him get up and went after him?

Yes!

Now, I had thought that the Ramseys denied that it WAS their flashlight. They had one that was similar, but they would not id it as theirs? The next question to me is, Was BR playing with his TRAINS. In the basement. When JBR came down.

 

[Tortoise]

That's a really good question. I'm so glad you asked, because it forced me to look at something in the AR I hadn't noticed before.

From the AR: "Upon reflection of the scalp there is found to be an extensive area ofscalp hemorrhage along the right temporoparietal area extending from the orbital ridge, posteriorly all the way to the occipital area." (The orbital ridge is the bony ridge below the eyebrow.)
The scalp hemorrhage indicates bleeding under the scalp, rather than on the scalp. Not the same thing we see in a bruise (hematoma) that we get in our skin. Bruising might been visible at some point, I suppose, but I really can't venture a guess.

But, because I re-read this line in the AR - I am now wondering about other issues, including the timing between the head blow and the ligature strangulation... and one more thing...

This is making me think really hard. I might need some time with this, but I'll give you my initial thoughts anyway. It isn't what I have been thinking prior to now. My gut tells me that this is saying that blood from the blow seeped downward - toward the right temporoparietal area from the orbital ridge and posteriorly all the way to the occipital area - which would mean that her head remained upright for some period of time after that blow.

I love these moments!

So, I shall try to get on board with you, even though I do drown in some of these long descriptions of parts of the anatomy. If I try to understand what you're saying, the blood seeped backwards from the eye area to the back of the head? Wouldn't that mean her head was tilted back? Or she's lying down with the back of her head on the floor?

 

[Tortoise]

The strike was on the top REAR of her head, so no bruising to her forehead.

The fracture extended all the way to just above her eye socket, I believe.

 

[kanzz]

I love these moments!

So, I shall try to get on board with you, even though I do drown in some of these long descriptions of parts of the anatomy. If I try to understand what you're saying, the blood seeped backwards from the eye area to the back of the head? Wouldn't that mean her head was tilted back? Or she's lying down with the back of her head on the floor?

I know, me too! But this one is making me about half ill.. because if I'm right, I think it means that JB was still awake for a while after she was struck in the head. eek!

So, I'm thinking the blood was seeping downward from the blow on the top of her head (around the skull) and then spread to the area near her brow and back to behind her ear.

Remember when we were little kids and we would play "break an egg" on somebody's head? Now do that on your own head, but not right in the center.. to the right a little and towards the back a little. Now bring your hand towards your ear and spread your thumb and fingers towards your eyebrow and behind your ear.

I generally don't like going down rabbit holes at all. But this one sentence in the AR has me thinking things I've never thought before.

 

[Tortoise]

I know, me too! But this one is making me about half ill.. because if I'm right, I think it means that JB was still awake for a while after she was struck in the head. eek!

So, I'm thinking the blood was seeping downward from the blow on the top of her head (around the skull) and then spread to the area near her brow and back to behind her ear.

Remember when we were little kids and we would play "break an egg" on somebody's head? Now do that on your own head, but not right in the center.. to the right a little and towards the back a little. Now bring your hand towards your ear and spread your thumb and fingers towards your eyebrow and behind your ear.

I generally don't like going down rabbit holes at all. But this one sentence in the AR has me thinking things I've never thought before.

If she was left lying on her back after the blow, and was then turned over onto her tummy, would that not have the same effect? What makes you think she was conscious, her upright position? What if she was being held upright, say being cuddled, by an adult sitting with her, for instance?