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Discrimination of Falls and Blows in Blunt Head Trauma: Assessment of Predictability Through Combined Criteria

NCJ Number
227720
Journal
Journal of Forensic Sciences Volume: 54 Issue: 4 Dated: July 2009 Pages: 923-926
Author(s)
Celia Kremer M.Sc.; Anny Sauvageau M.Sc., M.D.
Date Published
July 2009
Length
4 pages
Annotation
This study aimed to achieve a better rate for accurately distinguishing between head injuries caused by falls and those caused by blows to the head rendered by a person with some type of blunt instrument.
Abstract
The study proposed three criteria that were combined to develop a criteria tool. The study confirmed the "hat brim line" (HBL) rule, which maintains that a head wound located above the HBL is more likely to result from a blow administered by another person; whereas, a wound located below the HBL is more often related to a fall. For the 114 cases studied, 76.4 percent of lacerations and 75.9 percent of fractures located above the HBL were caused by blows administered by another person. A second confirmed criterion is related to "side lateralization," which was first proposed as a new criterion in a previous study by Kremer et al. This criterion holds that a left skull fracture is more often related to a blow, and a right skull fracture favors a fall. This is due to the high likelihood that a blow is administered by a right-handed person facing the victim and the likelihood that a head injury from a fall results when a right-handed person uses his/her right hand to protect from injury, causing the head to hit objects or surfaces with the right side of the head. A third criterion pertains to the number of lacerations. Lacerations in ground-level falls are known to be uncommon; whereas, blows are more likely to cause multiple lacerations. By combining the three aforementioned criteria, accuracy in distinguishing falls from assaults to the head reached 100 percent. Over a 6-year period, 114 cases (92 males and 22 females) were studied. They involved 21 cases of downstairs falls, 29 cases of falls from a person's own height, and 64 cases of head trauma from a blunt weapon. 1 figure, 6 tables and 7 references