site of injury
Injury may occur at any of the following sites; scalp, face, ears, skull, meninges and brain; injuries to the face are rarely fatal unless bleeding occurs into the airways, resulting in airway obstruction.
Common sites of injury following assault to the face are;
- maxilla/ mandible
- frenulum (particularly in child abuse)
The ears may be damaged, particularly following a kick to the side of the head. They may also be bitten in the course of an assault, particularly in cases of child abuse.
Injuries to the scalp may consist of abrasions, bruises, lacerations or incised wounds. Hair may 'cushion the blow' and obscure injuries, and it is often necessary to shave the hair aound an injury, at post-mortem examination, in order to facilitate the assessment and (photographic) documentation of the injury.
Bruising within the scalp is often associated with oedema and the site of the bruise may change over time as a result of gravity.
In particular, the 'black eye' may be due to;
direct trauma to the orbit
fracture of the orbital plates of the anterior cranial fossa, or
movement under gravity of a bruise from the forehead.
Lacerations of the scalp can lead to profuse haemorrhage and indeed death can occur due to massive blood loss from a 'simple' scalp wound. Sometimes, particularly in road traffic collisions, a large flap of scalp may be flayed off the skull.