Macroscopic findings of the skull and brain in fire fatalities - an update.

On the skull, the best known and most frequently observed autopsy findings are the heat fractures of the skull and the burn hematoma. The macromorphological changes of the brain have been described comparatively less frequently in the primary and secondary literature. We have evaluated the fire deaths of our institute over a period of 10 years with regard to the macromorphological changes of the skull and brain and described four stages (0-III) after postmortem fireexposure. In stage 0, the scalp showed up to third-degree burns, but the skull and brain were not affected. In stage I, in which the scalp showed fourth degree burns but the skull was still completely intact and unbroken, a certain hardening of the brain and a paling of the lateral parts of the temporal lobes, in particular, could already be regularly observed. In stage II, the head skin was burned away, and the skull was charred but still closed. There was a noticeable shrinkage of the dura mater, which was often torn. The brain itself appeared shrunken, pale and showed a flattening of the convolutions and a spreading of the furrows. In stage III, the skull was opened, charred to calcified and broken in clods. Tears in the dura mater led to herniation of brain tissue to the outside. The aim of this study was to classify the macromorphological changes of the skull and brain after fire exposure, both chronologically and according to their severity. The proposed staged classification (0-III) is intended to summarize the findings and to update and complement the descriptions in the older literature. It can be seen as an extension and further development of the Crow-Glassman scale, which classifies the extent of fire destruction of human bodies.