Autologous Bone Flap Resorption Years After Subtemporal Craniotomy

Authors

John Oladapo Obafunwa, University of Nebraska-LincolnFollow
Emily E. Hammerl, University of Nebraska-LincolnFollow
David Jaskierny, Pathologist and Coroners Physician, Omaha, Nebraska
Livia A. Taylor, University of Nebraska-LincolnFollow
Lynette Russell, Criminal Investigation Unit, Lincoln Police Department, Lincoln, Nebraska
Karl Reinhard, University of Nebraska-LincolnFollow

Document Type

Article

Date of this Version

2018

Citation

Published in Am J Forensic Med Pathol, Volume 39, Number 2, June 2018, pp 179-183.

DOI: 10.1097/PAF.0000000000000389

Comments

Copyright © 2018 Wolters Kluwer Health, Inc. Used by permission.

Abstract

In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury. Death was variously attributed to craniocerebral injury with hypothermia sequel to blunt force trauma most probably due to a fall. The manner of death was ruled as an accident. This study makes use of the forensic evidence and medical records to examine the possibility that the unique combination of failed cranioplasty, hypothermia, and neurocysticercosis may have contributed to the victim's death. Other potential causes of death are considered.