Tonight’s Hangout: Neurosurgeon Presents, “Neurosurgical Cold Case: Tomb of the Unknown Human”
(ED NOTE: Tonight, Tuesday, at 7pm at www.ArtOnCall.TV, this Hangout will occur; “Forensics Files” take note! Ammar Hadi MD, Neurosurgeon from Iraq, and Dr Deborah Benzil Vice President of the American Association of Neurological Surgeons, will be on panel)
This is Art on Call Episode 3 Tomb of the Unknown Human ~ Neurosurgery Cold Case.
All attempts to identify this individual through forensic methods and a journal article written by myself and Dr Ben Figura have failed. We are presenting this case with the hope that someone who sees this episode may be able to provide information leading to his identification.
In September of 2003, the body of an unidentified white male was found wrapped in plastic garbage bags in an industrial section of the Bronx. The deceased was in an advanced state of decomposition. The individual was 5’10” and, based on anthropological analysis, estimated to be between 40 and 60 years old. He was notably wearing a light-colored “Brooks Brothers” shirt with a laundry tag labeled “Felix.”
The ME asked me for help. When I saw this skull I knew I would have to paint it to fully understand it. This is a painting I did of the deceased’s skull. Here I am using art as a dissecting tool. Metallic implants in this case and in general use throughout the body can be helpful in the identification of the unknown deceased. Larger implants for example hip replacements, spinal implants have serial numbers. These plates and screws do not have numbers because of the small size.
The police investigation of this man’s death remains open. The New York City Medical Examiner’s evaluation has left the cause and manner of death as undetermined, but the probability of homicide is low. Of particular interest in this case is evidence of significant prior neurosurgical intervention.
Nalea J. Ko is a journalist in NY city she will be following the case and reporting back as the leads develop. Hello Nalea…
Do you have some add’l information to report
Thank you for chasing down the leads
Cranial plates and screws commonly are utilized to affix the bone flap to the calvarium after craniotomy or trauma. Based on the configuration of the bone flap and accompanying plates and screws, it is possible to suggest what type of surgery a person has undergone and assist in ascertaining the medical history.
Autopsy revealed that this person underwent an antemortem bifrontal craniotomy, with evidence of wiring of the right orbit inferiorly and laterally at the orbital-zygomatic process- RED ARROW. Additionally, there are plates and screws overlying the anterior wall of the frontal sinus. The blue arrows shows evidence of bone growth and remodeling of the burr holes. Note also that the nasal septum is asymmetrical, possibly a result of trauma.
Allow me to introduce Neurosurgeon, Dr Ammar Hadi Kadhim
Head of the scientific committee, Al-Hussein Teaching Hospital
Al-Samawa City, Iraq He is the sole neurosurgeon serving a population of 800,000. Dr . Even though we are both neurosurgeons it was Art that brought us together.
Ammar Hadi MD: Neurosurgeon from Baghdad, Iraq
Ammar Hadi MD, and Kathryn Ko MD
Hadi photographs were included in an art show that I curated for the Neurosurgical community.
Ammar Hadi MD: Neurosurgeon from Baghdad, Iraq: Having worked in Baghdad, you have a lot of experience with brain trauma. You also authored a paper on gravitational or falling bullets, and the resultant injuries. Give us your perspective on this case.
Dr Deborah Benzil is Vice President of the American Association of Neurological Surgeons and a close friend. For many years we operated together at a Level one Trauma center in the Bronx where we saw many cases such as this. Theres always 3 sides to a story. What do you think led this patient to surgery? As each painter has her own style and brush marks, each surgeon is different. This skull carries the marks of his surgeon or surgeons. I knew from the second I saw this skull that I had not done this surgery.
The frontal sinus has a 1-by-2.5-cm area of erosion on the posterior wall toward the right. The anterior fossa is intact, as is the crista galli. The orbital floor on the right is compromised with an area of missing bone YELLOW ARROW. In one of the dural tacking holes, a remnant suture can be found. PINK ARROW
The plates and screws have been identified as manufactured by Medtronic (Minneapolis) and appear to have self-drilling tips, possibly originating in the mid- to late-1990s. A survey of New York City hospitals using Medtronic implants of this type did not yield further information on this person. Some screws are blue-colored — presumably “rescue” screws with slightly larger diameters than the silver screws.. A CT scan did not yield additional information.