PMCT images of a motorcycle helmet-associated fracture

A 44 year-old male was involved in a head-on collision with a car which was overtaking another vehicle at the time. After being thrown from the motorcycle the deceased impacted to the car’s nearside, then to the rear offside curtain of an oncoming lorry before coming to rest on the opposite verge of the road. He was declared dead at the scene. The full-face SHOEI brand helmet worn had a witness mark to the front center just above the visor edge. There were multiple areas of bruising and abrasion to the head but no lacerations. Blood was noted to issue from the left ear. Post-mortem computed tomography (PMCT) identified a fracture of the base of the skull centered at the pituitary fossa extending to both middle fossae. It extended to the temporal bone of the vault, and along the lambdoid suture. The fracture did not quite meet at the back of the head, preventing dissociation between two skull portions (Fig. 1).