Dating skull fractures

Make note of whether there is a corresponding external contusion on the child’s head to help determine whether the subgaleal hemorrhage is a true impact site or not.When the scalp is reflected, the pathologist may locate a fracture that escapes visual detection by percussing the exposed skull.Most autopsies of the head begin with the pathologist shaving the head to look for bruises (contusions) on the outside surface of the scalp (left).If the autopsy has been done properly, the head should be shaved for careful inspection.Attorneys should obtain photos of this stage from the Medical Examiner for experts to review.

The pathologist will then remove the skull cap, exposing the brain.Little Ellie is alleged to have been beaten to death by her 'violent' 36-year-old father Ben Butler (pictured together, left, with her mother Jennie Gray) in a moment of rage.Her mother Ms Gray is pictured right Ellie's mother also denies child cruelty but has admitted perverting the course of justice by allegedly attempting to cover up for Butler by destroying evidence and lying to police about what happened.The so-called babygram is not an acceptable substitute.Bone scans are also able to detect radiographically occult fractures and should be considered when clinical suspicion is high. Rib fractures are easily missed so current practice is to repeat chest films in 2 weeks to observe for any healing rib fractures.

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