Basal skull fracture of non- traumatic origin - a case report

Abstract

Introduction The Interpretation of postmortem findings is based on internal and external examination of the dead body. Postmortem artifacts (PA) are changes/ features introduced after death that may be confused with features introduced ante mortem. We report a base of skull fracture in an extensively burnt body which was identified as a PA. This has not been reported in the literature. Case report A 58 -year old female was admitted to the emergency unit with extensive burns in a semiconscious state and died on the fourth day after admission. Burns involving approximately 60% of body surface were identified at autopsy. There was a linear, almost hinged fracture in the middle cranial fossa which was identified during the removal of vault of skull. Absence of bleeding around the fracture site, absence of soft tissue injuries of the head, face and rest of the body, normal brain and pattern of skull fracture confirmed that the fracture is of postmortem origin, which may have been caused during sawing and removal of vault of skull. Further, it was identified that the thickness of the skull was less than normal which may have contributed to this. Conclusion This case highlights the fact that basal skull fractures may occur as an autopsy artifact. Therefore accurate interpretation of such fractures is essential to ascertain the cause and manner of death.