Indirekte Orbitafrakturen nach okzipitalem Trauma (Geserick-Zeichen)

A 41-year-old woman was found unconscious in the bed of a nursing facility in the morning. At hospital admission, a spectacle hematoma, an occipital calvarial fracture, bilateral orbital fractures, frontal accentuated subarachnoid hemorrhage and cerebral contusions were diagnosed. The prognosis was considered to be infaust. Clinically, multiple acts of violence were assumed based on the injury pattern and the police were notified. A forensic medical examination was ordered to rule out third party causation. The externally visible scalp injury was a fresh abrasion on the back of the head. The clinical findings were confirmed in a separate forensic evaluation of the cranial computed tomography (CT). For the investigating authorities there were no indications for an external cause. In the synopsis of the police investigation results and the clinical and forensic findings, a fall event with occipital impact and indirect bilateral orbital fractures had to be assumed. The present case is only the second report of the so-called Geserick sign from the field of clinical forensic medicine.