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HSCA Forensic Pathology Panel On the Head Entrance Wound
Entrance (inshoot) wound of the back of the head
The bullet perforated no clothing prior to its penetration into the skin of the posterior scalp.
The panel examined photographs of the back of the head, including: Black and white negatives and prints Nos. 15 and 16; color transparencies Nos. 42 and 43; and correspondingly numbered color prints of the back of the head. These were studied with both the naked eye and 10X magnification. The photographs again all appear to have been taken from approximately the same position, and stereoscopic visualization of the two 4 by 5 inch color transparencies enables three dimensional perception. In the center of the photographs is a vertical centimeter ruler, which, by stereoscopic visualization, is demonstrated to be slightly closer to the camera than the adjacent skin surface. The upper portion of the ruler, which is in sharpest focus, is adjacent to a slightly oval scalp defect located in the "cowlick" area of the scalp just above or superior to a line drawn between the superior or upper margins of the area. (See fig. 13, a drawing of the back of the President's head.) This defect is partially covered by hair and dried blood. This wound is located considerably above the occipital protuberance, slightly to the right of the midline, and approximately 13 centimeters above the most prominent neck crease. It has a maximum vertical diameter in the photograph of approximately 1.5 to 2 centimeters, and maximum transverse diameter of approximately 0.9 centimeter.
FIGURE 13.--Drawing depicting the posterior head wound. Note also the position of the "white mass," described later.
Accurate reconstruction of the exact dimensions of the wound is difficult because the ruler and wound are in different planes of focus. The long axis of the wound more closely approximates a vertical angle than that depicted within the "Autopsy Descriptive Sheet? (See fig. 6.) The inferior margin of this wound, from 3 to 10 o'clock, is surrounded by a crescent-shaped reddish-black area of denudation, again presenting the appearance of an abrasion collar, resulting from the rubbing of the skin by the bullet at the time of penetration. From 12 to 3 o'clock, there is a suggestion of undermining, that is, tunneling of the tissue between the skin surface and the skull. Three small linear lacerations or tears of the skin, measuring less than 0.2 centimeter, in length, extend radially from the margins of the defect at 11 o'clock, 12 o'clock, and 3 o'clock. (See fig. 14:, a close-up photograph of this wound.)
FIGURE 14.--Close-up photograph of the posterior head wound.
An irregular, somewhat rectangular white object is also seen in these photographs, near the lower margin at the scalp hair at a point which most of the panel considers to be consistent with a localization slightly to the right of, and most likely below, the occipital protuberance. The panel agrees that the object is dried brain tissue.
Examination of the enhanced photographs prepared from the by 5 inch color transparency of the photograph of the back of the head (print No. 4g) reveals more sharply contrasted detail of the wound described in the upper occipital region and the dried brain tissue in the lower occipital region. stereoscopic visualization of this fragment indicates that it is adherent to and on the surface of the hair. computer-assisted image enhancement of this photograph reveals a dark oval shadow within the margins of the scalp perforation in the cowlick area which may be the perforation of the underlying skull. The hole in the scalp lines up with the hole in the skull. The X-rays also locate the skull defect at this point.
FIGURE 15.--Close-up photograph of the "white mass," dried brain tissue, situated in the lower occipital region.
Examination of the dried brain tissue in the lower occipital region by computer-assisted image enhancement also c]early demonstrates that it is on the surface of the hair. Such enhancement further provides some three-dimensional characterization. (See fig. 15, a close-up photograph of the dried brain tissue.) All members of the panel agree that the upper scalp wound, the location of which is identified by X-rays as approximately 10 centimeters (as measured on the X-ray) above the external occipital protuberance, is a typical entrance wound. All concur in its striking similarity to the entrance wound in the upper back. All agree that the white material is a piece of brain tissue and that it has no relationship to the location of the entrance wound, despite the interpretations of the autopsy pathologists in their Warren Commission testimony and interviews.
stereoscopic visualization of the inside of the cranial cavity at its depth, after removal of the brain, reveals a semicircular beveled defect of the inner table in the posterior parietal area to the right of the midline, from which fracture lines radiate corresponding to the entrance perforation indicated in the skull X-rays.
Skull X-ray No. 2, a lateral view of the head, reveals rather marked disruption of the smooth contour of the skull on the right side in the. temporal-parietal region, with multiple fractures through other portions of the skull. There is sharp disruption of the normal smooth contour of the skull 10 centimeters (as measured in the X-ray) above the external occipital protuberance, with suggested beveling of the inner table and with fracture lines radiating superiorly and inferiorly. (See fig. 16, showing the beveling process.) At this point there is an irregular, radiopaque, sharply outlined bullet fragment. The skull defect, apart from its location, corresponds with the description within the autopsy report, in which it characterized as follows:
In the underlying bone is a corresponding wound through the skull which exhibits beveling of the margins of the bone when viewed from the inner aspect
FIGURE 16.--Diagram depicting beveling which occurs on the interior surface the site of entrance and exterior surface at the site of exit when a missile perforates the skull.
The location of the missile fragment and transverse fractures of the occipital region of the skull is also apparent in the anterior posterior X-ray view of the skull (No. 1). It shows the missile fragment to be slightly to the right of the midline and in approximately the same vertical plane as in the above-described lateral view. (See figs. 17 and 18, photographs of X-rays Nos. 1 and 2 respectively.)
FIGURE 17.--Photograph of the anterior-posterior X-ray of the skull (autopsy X-ray No. 1), showing the occipital defect and adjacent missile fragment.
FIGURE 18.--Photograph of the lateral X-ray of the skull (autopsy X-ray No.2), showing the occipital defect with beveling and adjacent missile fragment.
<computer-assisted image enhancement> of this film more sharply delineates the fracture lines and bone fragments, as well as the missile fragment in the occipital region. The defect in the skull and the inward beveling thereof provide definite evidence of an entrance wound of the head at a point corresponding to that noted by the panel in the upper back of the scalp, rather than "slightly above" the external occipital protuberance as indicated in the autopsy report, or in the lower part of the head near the hairline, as stated by the autopsy pathologists in their interviews with the panel. (See figs. 19 and 20, and computer-assisted enhancements of X-rays 1 and 2 respectively. See also fig. 21, a photograph of a premortem X-ray of the skull of the President, against which :to compare the damage shown in autopsy X-rays Nos. 1 and 2.)
FIGURE 19.--Photograph of a computer-assisted image enhancement of anterior-posterior X-ray of the skull (autopsy X-ray No. 1).
FIGURE 20.--Photograph of a computer-assisted image enhancement of a lateral X-ray of the skull (autopsy X-ray No. 2).
FIGURE 21.--Photograph of a pre-mortem lateral X-ray of the skull of President John F. Kennedy, against which to compare the damage shown in the autopsy X-rays. Nos. 1 and 2.
4) Autopsy Report
The autopsy report localizes and characterizes the posterior head wound as follows:
Situated in the posterior scalp approximately 2.5 centimeters laterally to the right and slightly above the external occipital protuberance is a lacerated wound measuring 15 x 6 millimeters. In the underlying bone is a corresponding wound through the skull which exhibits beveling of the margins of the bone when viewed from the inner aspect of the skull. (34)
The "Autopsy Descriptive Sheet" shows a round circle overlying the occipital protuberance, with an arrow extending superiorly and to the left at approximately 11 o'clock and the notation "ragged, slanting, 15 by 6 millimeters." (See fig. 6.) Conspicuous by its absence is any descriptive legend which localizes this wound relative to body landmarks.
Dr. Finck, in his correspondence to Brigadier General Blumberg, made this observation concerning the entrance wound:
I also noticed another scalp wound, possibly of entrance, in the right occipital region, lacerated, and transversal, 15 by 6 millimeters. Corresponding to that wound, the skull shows a portion of a crater, the beveling of which is obvious on the internal aspect of the bone; on that basis, I told the prosecutors and Admiral Galloway that this occipital wound is a of entrance.
The panel was concerned about the apparent disparity between the localization of the wound in the photographs and X-rays and in the autopsy report, and sought to clarify this discrepancy by interviewing the three pathologists, Drs. Humes, Boswell, and Finck, and the radiologist, Dr. Ebersole. Each was asked individually to localize the wound of entrance within any one of several of the above-referenced photographs after reviewing the photographs, X-rays and autopsy report. In each instance, they identified the approximate location of the entrance wound on a human skull and within the photographs being in a position perceived by the panel to be below that described in the autopsy report. (See figs. 22 and 23, photographs of a human skull.) They also said it coincided with the rectangular white material interpreted by the panel as brain tissue present on top of the hair near the hairline. Each physician persisted in this localization, notwithstanding the apparent discrepancy between that localization and the wound characterized by the panel members as a typical entrance wound in the more superior "cowlick" area.
FIGURE 22.--Photograph of the posterior view of a human skull on which the autopsy pathologists, Drs. Humes, Boswell, and Finck, identified the approximate location of the entrance wound. The two initialed circles on the lower portion of the skull and to the right of the midline represent the general area where the autopsy doctors believe the entrance wound to be. (There arc two circles because Dr. Finck marked the skull independent of Drs. Humes and Boswell, and without knowing where Drs. Humes and Boswell had placed their circle.) The circle on the top portion of the skull and to the right of the midline represents the general area where the forensic pathology panel believes the entrance to be. (The fourth circle on the lower portion of the skull and approximately on the midline represents the location of the external occipital protuberance. )
FIGURE 23.- Photograph of the posterior-lateral view of the skull on which the autopsy pathologists identified the approximate location of the entrance wound. (See caption fig. 22.)
Drs. Ebersole, Finck, and Boswell offered no explanation for the upper wound, while Dr. Humes first suggested that it might represent an extension of a more anterior scalp laceration, incident to the exit wound, in spite of the fact that within the photograph the margins of the wound appear to be intact around the entire circumference. Dr. Finck believed strongly that the observations of the autopsy pathologist were more valid than those of individuals who might subsequently examine photographs.
The panel continued to be concerned about the persistent disparity between its findings and those of the autopsy pathologists and the rigid tenacity with which the prosecutors maintained that the entrance wound was at or near the external occipital protuberance. Subsequently, however, in his testimony before the select committee, Dr. Humes agreed that the defect was in fact in the "cowlick" area and not in the area of the brain tissue.
The photographs of the brain, described later, also support the panel's conclusions.
One panel member, Dr. Rose, wishes to emphasize the view of the majority of the panel (all except Dr. Wecht) that the absence of injury on the inferior surface of the brain offers incontrovertible evidence that the wound in the President's head is not in the location described in the autopsy report.
All members of the panel except Dr. Wecht concur that there one and only one wound of entrance in the head and that it is located in the "cowlick" area of the back of the head, and that the white substance referred to by the original prosecutors is a fragment of brain tissue. Dr. Wecht agrees that there is an entrance wound in the "cowlick" area and that the white substance is brain tissue, but he cannot exclude the possibility that it might overlie a very small skin and bone perforation of either entrance or exit. (See fig. 13, a drawing of the back of the President's head, with the wound as previously identified by the panel. It shows the adherent white brain tissue and the localization of the entrance wound as described within the body of the pathologists' autopsy report and during recent interviews. See also fig. 24, a drawing of the posterior view of a human body depicting the location of the entrance wounds in the head and the upper back.)
FIGURE 24. A drawing of the posterior view of a human body depicting the location of the entrance wounds in the head and the upper back.
Exit (outshoot) wound of the side of the head
The panel examined photographs of the face and head of President Kennedy, taken from the front and to the right including black and white prints No. 5 and 6 and color transparencies and prints Nos. 26, 27, and 28. These reveal a series of lacerations, described within the autopsy report as extending from an area in the right parietal region, anteriorly to the right frontal region, to a point 1 to 2 centimeters below the hairline; inferiorly and to the right, almost to the upper border of the tragus of the ear; and posteriorly toward the occipital region and to the left across the midline. There is a large skin flap in the right frontal region anteriorly and laterally, with two fragments an anterior compound fracture of the calvarium of the skull deflected outward and toward the right ear.
The photographs also show brain substance within the margins of the skin and skull defect, similar to the white material adherent to the hair in the right occipital-parietal region described above.
The panel also examined photographs taken from a position superior to the midportion of the President's head, including black and white prints Nos. 7, 8, 9, and 10 and color transparencies prints Nos. 32, 33, 34, 35, 36, and 37. These reveal many of the features described in the preceding series of photos, including brain substance in the right temporo-parietal region. A fragment of bone extends from the right fronto-temporal region.
Black and white photograph No. 17 and color transparency and print No. 44 are closeups of the margins of the fracture line the right frontoparietal region after reflection of the scalp. On the margins of this fracture line is a semicircular defect which appears to be beveled outward, although the photograph is not in sharp focus. computer-assisted image enhancement of this photograph revealed the defect more clearly. (See fig. 25, a closeup photograph of the semicircular exit defect on the margin of the fracture line in the right parietal region.
FIGURE 25.--Closeup photograph of the semicircular exit defect in the margin of the fracture fragment in the right parietal region.
Anthropologist Dr. Angel's evaluation of the "Harper bone fragment" (see below) indicates that it may include, a portion of the sagittal suture which is probably in apposition (corresponds) to this exit defect.
Left and right lateral skull X-rays Nos. 2 and 3, partly described above, when subjected to computer-assisted image enhancement, more clearly revealed the extent of the fractures of the temporo-parietal region and their extensions into the frontal and occipital portions of the skull bilaterally. The displacement of the residual fracture fragments in the right temporo-parietal region, with consequent overriding of several margins of the residual bony defect. is also apparent. (See fig. 20.)
Three additional X-rays, Nos. 4, 5, and 6, show three irregularly shaped pieces of skull recovered from within the President's limousine. The largest piece is almost triangular, with a serrated, or zigzag, edge on the longest straight margin, which the panel interprets as to be a portion of the right coronal suture. This edge meets a much sharper straight edge which represents an obvious fracture margin. At the junction of these two margins is a semicircular defect, described in the autopsy report as showing outward beveling, with small particles of radiopaque materials. These the panel considers to be missile fragments. (See fig. 26, an X-ray of the three bone fragments.)
FIGURE 26.--Photograph of an X-ray of the three bone fragments recovered from the limousine. These are depicted in X-ray films Nos. 4, 5, and 6. On the triangular fragment is the semicircular defect with outwardly beveled margins and radiopaque shadows which have the appearance of tiny missile fragments.
3) Autopsy Report
The autopsy report characterized the exit defect as follows:
1. There is a large irregular defect of the scalp and skull on the right involving chiefly the parietal bone, but extending somewhat into the temporal and occipital regions. In this region there is an actual absence of scalp and bone producing a defect which measures approximately 13 centimeters in greatest diameter. From the irregular margins of the above scalp defect tears extend in stellate fashion into the more or less intact scalp as follows:
· a. From the right inferior temporo-parietal region anterior to the right ear to a point slightly above the tragus.
· b. From the anterior parietal margin anteriorly on the forehead to approximately 4 centimeters above the right orbital ridge.
· c. From the left margin of the main defect across the midline entero-laterally, for a distance of approximately centimeters.
· d. From the same starting point as 10 centimeters posterolaterally. (36)
This description does little except locate the general area of convergence of the scalp lacerations. It is probably misleading in the sense that it describes "an actual absence of scalp and bone." The scalp was probably virtually all present, but torn and displaced; probably only the separately recovered bone fragments (described below) were absent. The description of the bone fails to recognize either the semicircular defect or any beveling in the bone fragments still attached to the head.
The note prepared by Dr. Finck for presentation to Brigadier General Blumberg, dated February 1, 1965, states, with respect to the exit wound:
No exit wound is identifiable at this time in the skull, but close to midnight, portions of cranial vault are received from Dallas, Tex. X-ray [sic] films of these bone specimens reveal numerous metallic fragments. Two of the bone specimens, 50 millimeters in diameter, reveal beveling when viewed from the external aspect, thus indicating a wound of exit. Most probably, these bone specimens are part of the very large right skull wound, 130 millimeter in diameter and mentioned above. This right fronto-parieto-occipital wound is therefore an exit. (37)
4) "Harper bone fragment"
The "Harper bone fragment" is a fragment of bone found near the scene of the assassination at 5:30 p.m. on November 23, 1963, by Billy A. Harper, then a premedical student. He was taking photographs of the assassination scene and, on finding the fragment, took it to his uncle, Jack C. Harper, M.D., who, in cooperation with A.B. Cairns, M.D., chief athologist at the Methodist Hospital in Dallas. had photographs taken on November 25, 1963, by M. Wayne Balleter. chief medical photographer at that hospital. Two 35 millimeter color transparencies of the convex and concave surfaces of the fragment, with an inch ruler in place, were picked up from Mrs. Jack C. Harper on July 10, 1964, by Special Agent Robert P. Gemberling of the FBI. The panel examined both these photographs and 8- by 10-inch black and white and color prints prepared from them.
J. Lawrence Angel, in a written memorandum addressed to the panel, dated October 24, 1977, characterized this fragment as follows (see addendum E for full text):
The Harper fragment photographs show it as a roughly trapezoidal piece, 7 centimeters by 5.5 centimeters in size, coming mainly from the upper middle third of the right parietal bone. Near its short upper edge vascular foramina on the inside and a faint irregular line on the outside indicate saggital suture. Its posterior inferior pointed edge appears to fit the crack in the posterior section of the right parietal [bone] and its slightly wavy lower border can fit the upper edge of the loose lower section of right parietal [bone]. Its upper short border, on the left of the midline near vertex, may meet the left margin of the gap. Behind it there appears to be a large gap and in front a narrow one. (38)
(See figs. 27 and 28, photographs of both the interior and exterior surfaces of the "Harper bone fragment.")
FIGURE 27.--Photograph of the interior surface of the Harper bone fragment.
FIGURE 28.--Photograph of the exterior surface of the Harper bone fragment.
5) Attempted reconstruction of the skull fractures
Paper cutouts were prepared to approximate the shape and size of the bone fragments demonstrated in X-rays Nos. 4, 5, and 6 and the photograph of the "Harper bone fragment." The panel attempted to locate the correct position of these fragments and them using the paper cutouts, to place these bone fragments on a human skull for the purposes of reconstruction. The largest of the X-ray fragments-that on which outer beveling and tiny metal fragments are evident--completes a portion of the exit perforation, with the suture line fitting into the coronal suture; the Harper bone fragment completes the circular perforation in the suture line immediately superior to the temporal bone. No other exit or entrance perforation is identified. (See fig. 29, a scale drawing of the frontal and right, side of a human skull, which shows the displaced bone fragments and the extensive fragmentation of the skull.) The sagittal suture follows the midline in the anterior-posterior direction, and is joined at approximately right angles by the coronal suture in front, which extends downward to the right and left sides, approximately midway between the outside margin of the orbit. and the outer ear canal. (See also fig. 30, another scale drawing, showing the path of the bullet through the head, and fig. 31, a drawing of a profile view of President Kennedy, showing the internal anatomic structure and the location of the entrance and exit wounds to the head (the entrance wound is only partially visible).
FIGURE 29.--Scale drawing of the frontal and right side of a human skull, which depicts the displaced bone fragments and the extensive fragmentation of the skull.
FIGURE 30.--Scale drawing which shows the path of the bullet through the head.
FIGURE 31.--A drawing of a profile view of President Kennedy, showing the internal anatomic structures and the location of the entrance and exit wounds to the head (the entrance wound is only partially visible).
The size of the exit defect is most accurately estimated from the X-rays of the largest separately received bone fragment, in which a segment of the circumference of the defect is demonstrated at one corner. Geometrically, by drawing a chord segment between the two extremities of this portion of the circumference and reconstructing a perpendicular radius, the central extremity of which is equidistant from all portions of this curve, the diameter of the defect is estimated to be 2.5 centimeters. This is consistent with the size of the defect as seen in the photographs, but cannot be determined more precisely because no ruler was present in the same plane.
According to Dr. Angel's report:
The two big loose fragments of skull vault, from upper frontal and parietal area more on the right than on the left side, do not articulate with each other and leave three appreciable gaps unfilled. (39)
Thus, the additional gaps may be accounted for by collapsed superimposed fragments of bone within the skull or there may still be fragments missing. Within one or several of these fragments, there might be an additional exit defect if the principal missile had divided into two major fragments within the skull, although in the experience of the members, the estimated size of the principal exit defect is consistent with the size of a single existing missile representing the mass of the two major fragments recovered outside the body.
The panel considered and rejected the possibility that if there were a residual defect, it might conceivably have been the location for an additional entrance wound. It did so because there was no radiographic evidence of such a missile within the skull, nor any observation or description of the effects of such a missile either on the skin, on the skull bones or within the brain.
One panel member, Dr. Wecht, suggests there is a remote possibility that a "soft-nosed" or frangible bullet could have struck the right side of the President's head in the exit defect leaving no visible evidence of a separate entrance wound. Further, according to Dr. Wecht in his dissent (which follows this report):
[s]ince this kind of ammunition would not have penetrated deeply into the brain, there would be no evidence of damage to the left cerebral hemisphere, nor would there be fragments of such a missile deposited in the left side of the brain. (40) <hscv7f.htm>
Dr. Wecht points out further that "there would not be a separate exit wound if this kind of ammunition had been used."(41)
All other members of the panel believe that such speculation about the timing and placement of separate wounds is without merit, and, further, they know of no soft-nosed or frangible missile that would disintegrate so completely on striking a surface as soft as the brain. There is no evidence of any such disintegration in the X-rays.
Course of the missile through the head
The panel examined photographs (including Nos. 17, 18, 44, and 45) they were taken from the front right side of the body, with the scalp reflected down and away from the fractured skull bones and with the brain removed. The lens was focused on the interior-posterior deepest portion of the wound, apparently in an attempt to depict the interior of the bullet perforation of the posterior region of the skull. In the photograph prepared from color transparency No. 45, the exterior bone fragment with the semicircular defect is more in focus than the base of the skull in the depth of the picture which is out of focus. In the photographs prepared from positive color transparency No. 45, the exterior fragment is out of focus but the depth of the photograph is in sharper focus. The photographs, also studied using the computer-assisted enhancement technique, show a possible portion of the beveled inner table corresponding to the semicircular margin of the entrance wound at the back of the head in the right posterior parietal bone. Color transparencies and prints Nos. 46,47, 48, and 49 and black and white prints Nos. 19, 21, and 22 reveal the inferior aspect of the brain, with extensive fragmentation and laceration of the right inferior cerebral hemisphere, some loss of cerebral substance on the inferior surface of the left temporal lobe, and scattered areas of subarachnoid hemorrhage in the underlying cortex The right sylvian fissure shows dark red-brown to black discoloration suggestive of blood clot. The surface of the midtemporal region is lacerated and depressed. The cerebral peduncles( ) are likewise lacerated. The panel notes that the posterior-inferior portion of the cerebellum virtually intact. It certainly does not demonstrate the degree of laceration, fragmentation, or contusion (as appears subsequently on the superior aspect of the brain) that would be expected in this location if the bullet wound of entrance were as described in the autopsy report. There is no damage in the area of the brain corresponding to the piece of brain tissue on the hair which the autopsy pathologists told the panel was the entrance wound.
The panel examined the photographs of the superior aspect of the brain, including color transparencies and prints No. 50, No. 51 and No. 52 and black and white prints No. 20, No. 23, No. 24 and No. 25. The left cerebral hemisphere is covered by intact arachnoid beneath which dark brown to black subarachnoid hemorrhage is most prominent over the frontal and parietal gyri and within the adjacent sulci. On the right cerebral hemisphere is an anterior-posterior cylindrical groove in which the brain substance is fragmented or absent. This groove extends from the back of the brain to the right frontal area of the brain and contains within the depths of its central portion a greybrown rectangular area. The majority of the panel considers this to be a blood vessel in the sylvian fissure.
The majority of the panel members agrees that examination of the brain itself even now would substantiate this opinion. One member, Dr. Wecht, can justify no such opinion without first examining the brain itself.
Laceration of the corpus callosum within the deep margins of the wound of the right cortex is also evident (see fig. 32, a drawing of the superior surface of the brain).
FIGURE 32.--Drawing of the superior surface of the brain, showing the extensive lacerations.
The panel examined X-ray films of the anterior-posterior view of the skull (No. 1) and left (No. 2), and right (No. 3) lateral views of the skull with the naked eye and with 10 x magnification. Film No. reveals the defect referred to above in the posterior parietal region. in it location corresponding to the previously described skin defect in the "cowlick" area of the scalp. Embedded in the skull in the lower margin of this defect is a radiopaque shadow which, in the opinion of the panel, is a fragment of the missile. This shadow is 10 centimeters above the external occipital protuberance and 2.5 centimeters to the right of the midline in this film. One surface of this fragment, visualized in film No. 1, is round. The maximum diameter of the fragment measures 0.65 centimeter.
Within the right side of the head are randomly distributed, irregularly shaped, radiopaque shadows which are missile fragments. These shadows, measuring from 0.2 to 0.6 centimeter in diameter, extend from the back to the front; the largest one is present beneath the skin in front. Another group of smaller,, more uniform, shadows, 0.1 centimeter less in diameter, so-called missile dust, forms a cylindrical pattern, with the axis directed anterior-posterior, approximately paralleling the sagittal plane, and extending toward the large bony defect in the right temporal-parietal region on the right side of the head. The long axis of this grouping, if extended backward, approaches the entrance defect and missile fragment in the right side of the back of the head.
The panel considered the location and grouping of the smaller missile fragments seen in films Nos. 2 and 3 and suggests that the extensive fragmentation and disruption of the skull bones, and the movement of the body after death, could have caused movement of the missile fragments in movable portions of skin, bone, and brain. The panel also noted the absence of any metal fragment within the left cerebral hemisphere, as demonstrated in film No. 1, although a number of extensive fractures involving the upper portion and base of the right skull extend across the midline.
The panel also noted several artificially caused defects on these films. Two round, puckered areas on film No. 1 were apparently due to examination under a high intensity light that was too close. Dr. Ebersole advised the panel that he placed the converging pencil lines on film No. 2 after the autopsy, pursuant to an official White House, request to obtain certain anthropometric measurements for a sculptor. None of these defects interfered with accurate interpretation of these films.
In March 1978, Dr. McDonnel of Los Angeles, examined the skull films for the panel and reported:
My preliminary (prior to analysis of computer-assisted enhanced images of these X-rays) interpretation follow (sic):
A nearly complete loss of structure in the right frontal and parietal bone.
A metallic fragment on the outer table of the right occipital bone approximately 10 centimeters above the external occipital protuberance. In the same area is a depressed fracture. In the anterior-posterior projection, there appears to be fracture lines to the occipital, parietal and temporal bone, radiating from the area of the fracture and metallic fragments. The metallic fragment is nearly spherical in this projection.
There is elevation of the galea roedial and lateral to the area of the fracture and metallic fragment in the occipital region. A small metallic fragment is located medial to the location of the spherical metallic fragment and fracture between the galea lying and the outer cranial table.
There is a fracture line through the floor of the sella turcica with bony fragments in the sphenoid sinus.
There are fracture lines through the anterior and posterior aspects of the anterior ethmoid cells with air in the right side anterior ethmoid. (42)
Dr. McDonnel further examined these films using computer assisted enhancements of the anterior-posterior (fig. 19) and left lateral (fig. 20) views and submitted a more detailed report on August 4, 1978. Such separation of the galea from the outer skull bones often occurs as a result of the dislocation of adjacent bone fragments and is seen in an explosive-type injury to the skull. The location of the metallic fragment inside the galea , medial to the defect in the skull representing the initial penetration, suggests that this separation commenced on initial impact, allowing the tiny above-described missile fragment to be displaced medially within this space created by explosion (between the skull and its overlying galea). Dr. McDonnel also indicted that such dislocation of this and other missile fragments might have occurred as a consequence of manipulation of the head prior to, during or following transit, but prior to the X-ray examination of the skull, although such medial dislocation would not be expected as a consequence of gravity alone.
Dr. Chase, during his examination, noted the presence of extensive comminuted fractures of the calvarium. He said that the extensive damage apparent from the X-ray precluded interpretation of exactly what happened to the top of the skull, based on radiographic examination alone. He indicated that he saw no evidence of any posterior missile perforation apart from one in the posterior parietal area. Stated more explicitly, there was no perforation in the area of the external occipital protuberance. He further indicated that the degree of damage to the skull and the fact that there was "little residual material" (relatively small amount of bullet fragments present) led him to believe that the missile was jacketed. He said further that there was no evidence in the X-rays of a shot coming from the front or of more than one bullet striking the skull. Dr. Chase indicated that for there to be a second entrance perforation, there would have to be another exit point in the skull or a bullet that was left behind, neither of which is present.
Dr. Davis described the entrance wound visible in the X-rays as follows:
There is an extensive comminuted, open, explosive calvarial fracture which seems to radiate in various directions as described above from a central point which is located in the right parietal bone, 3 centimeters from the midline and about 9 or 10 centimeters from the external occipital protuberance. (43)
The panel understands the vertical distance mentioned above to mean 9 or 10 centimeters above the horizontal plane through the external occipital protuberance.
3) Autopsy report
The autopsy report describes the track of the missile through the head as follows:
Clearly visible in the above described large skull defect and exuding from it is lacerated brain tissue which on close inspection proves to represent the major portion of the right cerebral hemisphere. At this point it noted that the falx cerebri is extensively lacerated with disruption of the superior sagittal sinus. Upon reflecting the scalp, multiple complete fracture lines are seen to radiate from both the large defect at the vertex and the smaller wound at the occiput. These vary greatly in length and direction, the longest measuring approximately 19 centimeters. These result in the production of numerous fragments which vary in size from a few millimeters to 10 centimeters in greatest diameter. The complexity of these fractures and the fragments thus produced tax satisfactory verbal description and are better appreciated in photographs and roentgenograms which are prepared. (44)
The panel acknowledges the difficulty of and necessity for describing the fractures and suggests that the autopsy examination at the very least should have noted evidence in the skull and scalp that would assist in localizing the exit wound. An appropriate examination would have included replacement of the bone fragments in approximate anatomic position and then description of the missile track from the entrance to the exit wound.
The autopsy report states that: "The brain is removed and preserved for further study following formalin fixation." (45) The brain, which had been fixed in formalin, the chemical preservative normally used to prevent deterioration, was further examined. The results are described in the "Supplementary Report of Autopsy No. A63-272, President John F. Kennedy" (Commission Exhibit No. 391). This document observes:
Following formalin fixation the brain weighs 1500 grams. The right cerebral hemisphere is found to be markedly disrupted. There is longitudinal laceration of the right hemisphere which is a parasagittal in position approximately 2.5 centimeters to the right of the midline which extends from the tip of the occipital lobe posteriorly to the tip of the frontal lobe anteriorly. The base of the laceration is situated approximately 4.5 centimeters below the vertex in the white matter. There is considerable loss of cortical substance above the base of the laceration, particularly in the parietal lobe. The margins of this laceration are at all points jagged and irregular, with additional lacerations extending in varying directions and for varying distances from the main laceration. In addition, there is a laceration of the corpus cellosum extending from the genu to the tail. Exposed in this latter laceration are the interiors of the right lateral and third ventricles. When viewed from the vertex the left cerebral hemisphere is intact. There is marked engorgement of meningeal blood vessels of the left temporal and frontal regions with considerable associated subaracbnoid hemorrhage. The gyri sulci over the left hemisphere are of essentially normal size and distribution. Those on the right are too fragmented and distorted for satisfactory description. When viewed from the basilar aspect the disruption of the right cortex is again obvious. There is a longitudinal laceration of the midbrain through the floor of the third ventricle just behind the optic chiasm and mammillary bodies. This laceration partially communicates with an oblique 1.5 centimeter tear through the left cerebral peduncle. There are irregular superficial lacerations over the basilar aspects of the left temporal and frontal lobes. (46)
The panel notes that the brain was not coronally sectioned, a standard pathological practice which permits examination of the inside of the brain. Rather, as evidenced in the autopsy report, supplemental report and Dr. Humes' testimony before the Warren Commission,(47) the brain was preserved intact without a complete examination. Only very limited microscopic sections were taken. The panel stresses that coronal sectioning is the most acceptable and accurate method of determining precisely the effects of a missile on the brain, as well as the angle of a bullet track in the head. The failure to section the brain also precluded collection of interior samples for microscopic study.
The panel members do not concur with the rationale for having limited the examination in this way. The brain should have been scientifically examined, with sectioning and description of the interior injuries. Only those portions necessary to document the findings need have been retained as evidence for potential court proceedings or for other purposes.
The autopsy report lists the outer brain areas from which sections were taken for microscopic examination:
· a. From the margin of the laceration in the right parietal lobe.
· b. From the margin of the laceration in the corpus callosum.
· c. From the anterior portion of the laceration in the right frontal lobe.
· d. From the contused left fronto-parietal cortex.
· e. From the line of transection of the spinal cord.
· f. From the right cerebellar cortex.
· g. From the superficial laceration of the basillar aspect of the left temporal lobe.
These sections are described as follows:
Microscopic examination--Brain.--Multiple sections from representative areas as noted above are examined. All sections examined are there significant abnormalities other brain tissue with associated hemorrhage. In none of the sections examined are there significant abnormalities other than those directly related to the recent trauma.(49)
The summary within the autopsy report contains this statement concerning the missile pathway:
The fatal missile entered the skull above and to the right of the external occipital protuberance. A portion of the projectile transversed the cranial cavity in a posterior-anterior direction (see lateral skull roentgenogram) depositing minute particles along its path. A portion of the projectile made its exit through the parietal bone on the right carrying with it portions of cerebrum, skull and scalp. The two wounds of the skull combined with the force of the missile produced extensive fragmentation of the skull, laceration of the superior sagittal sinus, and of the right cerebral hemisphere. (50) <hscv7f.htm>
The summary concludes:
In addition, it is our opinion that the wound of the skull produced such extensive damage to the brain as to preclude the possibility of the deceased surviving this injury.
The panel concurs with this opinion.
Dr. Finck, in his personal note to Brigadier General Blumberg dated February 1, 1965, added this additional information on the observation of the head wound:
The scalp of the vertex is lacerated. There is an open comminuted fracture of the crimal vault, many portions of which are missing. The autopsy had been in progress for 30 minutes when I arrived. Commander Humes told me that he only had to prolong the lacerations of the scalp before removing the brain. No sawing of the skull was necessary. The opening of the large head wound, in the right fronto-parieto occipital region, is 130 millimeters in diameter.(51)
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