There is not much there between that damage and his brainpan. He blew his whole oropharyngeal region out, and blew off his jaw and his entire maxillary and nose area (implying a huge amount of force), so that would imply that there should be some serious damage in the other direction as well, namely the direction of his brain, which is not so well protected from that angle of attack.
It does not appear that he is even intubated. Is he dead and just appears alive? It seems that the very first thing you wold do to a guy like that on scene is intubate him. How is he breathing and not drowning on his own blood? Why aren't they stopping that huge amount of bleeding instead of standing around taking pictures? Many questions.
I cannot see how a mechanism of injury could cause all that damage and not blast fragments etc into the brain. The blood looks a little oddly colored than from what I have seen from such injuries. I have my doubts that the pic is not altered somehow.
But, I am not a doctor, I am only pretending to be one. I am a certified EMT though and worked in a ER among other things so I guess I should give myself some credit though.
[This message has been edited by Red Bull (edited August 25, 2000).]