The Discrepant Severity of External and Internal Injuries in a Traffic Accident: The Cushioning Effect via a Human Body Against Direct Impact: Autopsy CasesNishitani, Yoko MD, PhD; Okazaki, Shunichiro MD, PhD; Suzuki, Kengo MD; Imabayashi, Kiyomi DDS, PhD; Katada, Ryuichi MD; Matsumoto, Hiroshi MD, PhDAmerican Journal of Forensic Medicine & Pathology: June 2009 - Volume 30 - Issue 2 - pp 186-187 doi: 10.1097/PAF.0b013e3181879ceb Case Report Abstract Author Information Traffic accidents cause unexpectedly severe injuries of internal organs despite tiny injuries observed on the external body. A 51-year-old woman (subject 1) and a 54-year-old man (subject 2) were found dead on a road. Subject 1 had subcutaneous and intramuscular bleeding with décollement on the posterior aspect of her body, including upper cervical spine dislocation. Subject 2 did not exhibit any apparent findings on autopsy that were indicative of a direct injury by a motor vehicle, but had severe internal organ injuries, including the transection at the pontomedullary junction. We surmise that subjects 1 and 2 were walking in line with the vehicle which collided with them from behind, and then the body of subject 1 cushioned the direct impact of the vehicle against subject 2. This report illustrates the need of forensic autopsy for victims with no severe external injuries. From the Department of Legal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. Manuscript received June 17,2007; accepted March 2, 2008. Reprints: Yoko Nishitani, MD, PhD, Department of Legal Medicine, Sapporo Medical University School of Medicine, South 1, West 17, Sapporo 060-8556, Japan. E-mail: firstname.lastname@example.org. © 2009 Lippincott Williams & Wilkins, Inc.