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The Anatomy of an Assassination


Sheri L. Boyce
Department of Biological Sciences
Messiah University


This case study, presented in the form of two mini-cases, is based on the story of Abraham Lincoln’s assassination by John Wilkes Booth. The first mini-case focuses on Lincoln. After learning about the medical details of the shooting, Lincoln’s injury, and the vigil kept by physicians until his death, students are asked to predict the brain structures damaged by the bullet and explain how increased intracranial pressure could produce many of the signs the physicians observed. The second mini-case focuses on Booth, who suffered a spinal cord injury when he was fatally wounded in the neck during his capture. Students use knowledge of spinal cord and cervical anatomy to connect Booth’s observed neurological deficits to autopsy records describing the tissue damage. Through both cases, students consider the functional anatomy of major brain and spinal cord structures. Originally written for an upper-level undergraduate neuroscience course for majors, the case could potentially be adapted for a non-neuroscience course, though if used in that context, it may require significant revisions depending on the material presented in that course.


  • Demonstrate knowledge of three-dimensional anatomy of major regions of the brain.
  • Describe the general functions of the brainstem and the consequences of injury.
  • Explain how the anatomical relationship of the brain and the dura mater leads to brain injury when intracranial pressure rises.
  • Explain the underlying anatomical cause of the typical signs of uncal (tentorial) herniation.
  • Predict injury sustained to spinal cord and spinal nerves based on damage to surrounding vertebrae, and the ensuing deficits.
  • Predict if an injury will produce an upper or lower motor neuron syndrome.
  • Understand the role of the cervical spinal cord and nerves in respiration.


Brain; intracranial pressure; ventricles; meninges; herniation; spinal cord; neuroanatomy; spinal cord injury; vertebra; upper motor neuron; phrenic nerve; tentorial notch; Lincoln; Booth

Topical Areas


Educational Level

Undergraduate upper division



Type / Methods

Directed, Mini-Case



Subject Headings

Anatomy  |   Medicine (General)  |   Neuroscience  |  

Date Posted


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