Tuesday, August 2, 2016

Lions and tigers and bears! Oh my! 2

Emami P, Kaiser TM, Regelsberger J, Goebell E, Fiehler J, Westphal M, Heese O.
Case report: surviving a tiger attack. Neurosurg Rev. 2012 Oct;35(4):621-4.


Attacks on humans by large predators are rare, especially in Northern Europe. In cases of involvement of the craniocervical compartment, most of the attacks are not survived. We report on a case where the patient survived a tiger attack despite severe head trauma and discuss the circumstances leading to the patient's survival and excellent outcome. The patient we report on is a 28-year-old tamer, who was attacked by three tigers during an evening show. A bite to the head resulted in multiple injuries including left-sided skull penetration wounds with dislocated fractures, dural perforations, and brain parenchyma lesions. The patient recovered without neurological deficits after initial ICU treatment. No infection occurred. In order to understand the mechanism of the tiger's bite to the patient's cranium, a simulation of the attack was performed using a human and a tiger skull put together at identical positions to the bite marks in a CT scan. It seems that during the bite, the animal was not able to clamp down on the patient's skull between its canine teeth and therefore reduced bite forces were applied. Survival of an attack by a large predator that targeted the cervical-cranial compartment with an excellent outcome is not described in the literature. We were surprised to find only minor lesions of the brain parenchyma despite the obvious penetration of the skull by the tiger's canines. This seems to be related to the specific dynamics of the cranial assault and the reduced forces applied to the patient's head demonstrated in a 3D bite simulation.


  1. A German animal trainer is in a critical condition after he was pounced on and mauled by three Bengal tigers at a celebrity circus event.

    Christian Walliser, 28, an experienced tiger trainer, was attacked after he stumbled during the show in Hamburg. The 200 guests watched in horror as Walliser was pinned to the ground by the tigers.

    Members of the audience, who had each paid €132 (£120) to attend the Dinner Circus, were on the starter of a five-course meal as Walliser came into the ring to perform his show with five tigers.

    At first onlookers thought it was part of the act as he fell, and three of the tigers immediately pounced on him. "Initially it looked like they wanted to play with him," one of the audience told German media.

    The tigers dug their teeth into Walliser's head and upper body, tearing off most of his left hand.

    Within 30 seconds other trainers ran to his aid, using water cannons and fire extinguishers to forced the tigers back into their cages.

    Eyewitnesses said those quick actions probably saved his life.

    A doctor who happened to be in the audience was able to stop the worst of the bleeding before medics appeared.

    Walliser was rushed to nearby Eppendorf hospital where emergency surgery was performed…

    Doctors amputated Walliser's left hand and said he had suffered serious head and chest injuries in the attack. He remains in a critical condition.

    The event took place last night at the Hagenbeck Dressage hall, one of the oldest active circus venues in Europe. Hamburg Tierpark, owners of the venue, said it "deeply regretted" the incident.


  2. A colleague wrote: I’ve long wondered whether or not a case report of a clearly public case found from a simple Google search represents some sort of a confidentiality violation. The famous case of the British au pair Louise Woodward “shaken baby” [see http://childnervoussystem.blogspot.com/2016/08/physician-statement-on-louise-woodward.html] was also reported in the New England Journal of Medicine. The NEJM surgical report on that child was particularly graphic.