Full horror of Oklahoma teen Noah Presgrove's injuries explained - as autopsy results give chilling insight into his final moments

Noah Presgrove suffered dozens of horrific injuries from broken bones to smashed teeth, brain damage, and bleeding inside his skull and chest before he died naked by a lonely highway.

The teenager, 19, was wearing only two mismatched shoes when his body was discovered on a desolate stretch of US-81 near Terral, Oklahoma, on September 4.

He was last seen alive about a mile away at a four-day 22nd birthday party with friends over the Labor Day weekend that was heavily documented on social media.

Oklahoma Chief Medical Examiner Leonardo Roquero ruled Presgrove died of 'multiple blunt force injuries', but how he got them was 'undetermined'.

His autopsy report released on Monday detailed extensive injuries to the teen's upper body, including 10 broken ribs, serious skull, neck, and spine fractures, internal bleeding, brain and organ damage, and cuts and grazes all over his body.

DailyMail.com mapped out Presgrove's injuries on anatomical diagrams to show the full horror of the ordeal he suffered before his death as his family fights for answers.

Noah Presgrove, 19, was wearing only shoes when his body was discovered on a desolate stretch of US-81 in Terral, Oklahoma, on September 4

Presgrove suffered external injuries to his face and head that night. The most serious was the chunk of scalp that was torn off his head all the way down to the bone that coincided with the massive internal injuries to his skull and brain that were at their worst at the top and back of the head. The piece of scalp and hair was found on the highway feet away. Many of Presgrove's teeth were also broken and some were knocked out and found on the road

Presgrove is believed to have died from massive internal bleeding before his other injuries had a chance to end his life. All up, he lost at least 3.2 pints of blood from two punctured lungs, damage to vital organs, and extensive tissue damage. A man Presgrove's size has about 12.6 pints of blood, and would generally die after losing half of it - though as little as a third can lead to death

There was one extensive skull fracture running across his head, 'splitting the middle base of skull into two', and two smaller ones, with police investigators describing his head as being 'caved in'.

He had about 20ml, or 0.68oz, of blood pooled inside his head from a brain bleed, damage to four parts of the brain itself.

There was also air in both his cranial cavity and spinal cord, extremely rare conditions only caused by massive head trauma. 

Both lungs were punctured and he had internal injuries to his heart, spleen, and stomach and internal bleeding of at least 1,550ml - about 3.2 pints.

A man Presgrove's size has about 12.6 pints of blood, and would generally die after losing half of it - though as little as a third can lead to death.

The skin on left side of his scalp was torn off to the bone and a clump of hair and skin was found in the middle of the highway.

'Additionally, a clump of hair was observed on the right buttock without blood or tissue,' Roquero wrote.

There was one extensive skull fracture running across his head, 'splitting the middle base of skull into two', and two smaller ones, with police investigators describing his head as being 'caved in'. The large fracture is known as a 'hinge type' for its distinctive shape. Presgrove also suffered damage to a muscle on the side of his head, which is used for chewing

The skull fractures and scalp tearing caused bleeding inside his head both above and below the skull. The most was at the back of his head in what's known as a subdural hemorrhage - below the dural layer under the skull that carries fluid around the cranium - where there was 20ml, or 0.68oz, of blood pooled. There was also air in both his cranial cavity and spinal cord, extremely rare conditions only caused by massive head trauma

Both his upper and lower teeth were broken 'with few fragments and found inside the mouth' and others strewn across the road several feet from his body.

He was bleeding out of his ears and had a cut on his lower lip and one on his tongue.

Presgrove's C1, C2, C6, C7 vertebrae were fractured to varying degrees and C1 was displaced - indicating a seriously broken neck of the same kind that people who are executed by hanging suffer.

He had road rash on upper back and abrasions from grazes on his left shoulder, left arm, left side of torso, and both buttocks.

Other grazes were on his left eyebrow, corner of the left eye and left cheek, left ear, right neck, and behind his right ear.

Presgrove had healed abrasions and scabs on his nose, both hands and knuckles, left foot and heel, round healing ulcer on right thigh - all of which predated the injuries from that night.

Presgrove's C1, C2, C6, C7 vertebrae were fractured to varying degrees and C1 was displaced with his head being pushed forward from his spine - indicating a seriously broken neck of the same kind that people who are executed by hanging suffer

Presgrove suffered fractured to nine vertebrae in his spine, mostly at the back of the bones in the knobs you can feel if you touch your spine with your hand. There were also fractures to 10 ribs - all close to the spine and mostly in the upper back

Roquero wrote that there were 'no vehicle parts or debris observed on the scene', indicating Presgrove was almost certainly not hit by a car. 

'He was naked and was only wearing unmatching shoes. There was a pair of shorts found several feet from the decedent and was reported to be his,' Roquero wrote.

'Additionally, there were three pieces of a white metal chain as well as part of a tooth present several feet from the decedent.'

Roquero noted there was 'a drawing in black ink of a stick-figure person on the side of the right thigh'.

A video from the Saturday night of the party, on September 2, showed Presgrove's friends drawing their names and other doodles on his back and buttocks.

He went home and washed some of it off, but is believed to not have been able to get all of the marker off before he went back to the party the next evening.

Presgrove had comparatively minor external injuries to the front of his body. Most of the grazes were patchy and in some cases the spots were round and the size of a coin or smaller

Presgrove had road rash above his upper back, with black material from the road lodged in the wounds. There were also grazes on both buttocks despite the shorts found near his body being undamaged

The Adidas shoe Presgrove was wearing was his, and the other, a 'Hey Dude' slip-on, was from another party guest who was asleep at the time.

The shorts he was wearing were undamaged, despite the grazes on his buttocks, and the slip-on shoes had grass and other debris lodged in them.

Presgrove had a blood alcohol level of 0.14, but no drugs in his system. 

Dr Stuart Fischer, an internist doctor with extensive experience in emergency medicine, reviewed the report for DailyMail.com and said the injuries were so catastrophic and varied that him being mortally wounded in a severe beating was the most likely cause.

'The poor kid never had a chance... My guess would be injury by several different things at the same time, namely several different people at the same time,' he said.

He said it was unlikely one person caused all Presgrove's injuries because they were far in excess of what was needed to kill him - unless it was a 'crime of passion'.

Presgrove's body was found between the two chalk lines, and teeth within the circles. In the background is a memorial set up for the teenager

Oklahoma Chief Medical Examiner Leonardo Roquero ruled Presgrove died of 'multiple blunt force injuries', but how he got them was 'undetermined'

Dr Fischer was shocked to see there was little mention of blood at the scene, and hear how multiple sources told DailyMail.com that there was almost none when they saw his body lying on the roadside.

'Really? Well maybe the body was moved. There would be pools of blood and if you're not seeing that, an explanation could be that's what happened,' he said.

Another leading theory police are investigating is that Presgrove fell, or was pushed, from the back of a pickup truck and hit his head on the road.

'It's possible,' Dr Fischer said, but noted the lack of serious injuries to Presgrove's lower body, which only had a few cuts and scrapes, and there would likely have been more from him rolling on the road.

Dr Fischer said Presgrove would have bled to death, but his breathing would also have been affected by his torso injuries. 

The Oklahoma Highway Patrol, which is leading the investigation, two weeks ago gave its first update since last September.

Presgrove's family (pictured with his sister Madison Rawling) were confused by aspects of the report but said they had confidence in the investigation

Presgrove's autopsy ruled he died of 'multiple blunt force injuries', but how he got them was 'undetermined'

'Currently, the OHP is not investigating Presgrove's death as a murder,' it said.

'The investigation is not over, and anyone with information on Presgrove's death is encouraged to contact [us].'

This was despite friends and family who saw his body saying his badly battered face 'looked like he got beat up by five dudes'.

Not investigating the teen's death as a murder does not mean police have ruled out manslaughter, and detectives are considering competing theories.

'We would like to publicly thank the team that are working in unison tirelessly to navigate what has always been called as a suspicious death, not a murder which is killing by premeditation,' Presgrove's family said in a statement.

'We understand everyone’s frustrations more so than anyone. However, we ask that everyone be mindful of their dedication and perseverance in finding answers.'

The Oklahoma State Bureau of Investigation called Presgrove's death 'suspicious' in the days after his body was found.

He was last seen alive at the four-day 22nd birthday party with friends over the Labor Day weekend that was heavily documented on social media

Presgrove's body was found about a mile north along the highway from the small street where the party was held

The report also vaguely explained some of the events leading up to Presgrove's disappearance and discovery on the highway.

'Then he rode an ATV ranger vehicle with several men that had a roll over incident. The decedent was alive following the incident and returned to the party where he got into an argument with his girlfriend,' it read.

'The decedent left the house party and was not found until the morning of September 4, 2023, on the side of the highway.'

Presgove's best friend Jack Newton, who was at the party but claimed he was asleep when he disappeared, said it was his ATV that was in the accident. 

'All of all close friends said that he wrecked my SXS I had there around 3,' he wrote in a message to another friend.

'And he was super dirty and super drunk so a couple of girls helped him in the shower.'

Presgrove's family said they were confused by the reference to his 'girlfriend' as he was single.

Newton explained this in the same conversation: 'When he got out [of the shower] he wanted to sleep in one of the girls' bed and she [said no and] that upset him and he walked off.'

Presgrove was a high school football player until his graduation in May

A friend who wasn't at the party questioned one of the teenagers in the weeks that followed about what happened to cause his facial injuries

During the same conversation, the other friend asked how Presgrove got the horrific injuries he suffered to his face that appeared to be from a beating.

'Bro, everyone that saw Noah at the viewing, including me, saw his face was beat up bad,' he wrote in a message shared with DailyMail.com.

'I know what a beat up face looks like. Definitely not just me saying that. Everyone that saw him said that.

'Looks like he got beat up by five dudes.'

Other people who saw his body said it looked like his nose and cheek were broken. 

The damage to his face was in addition to other injuries to the back of his head and upper body Presgrove suffered, and added fuel to fears he was murdered.

Oklahoma Highway Patrol detectives, who are leading the investigation, are still unsure how he died, and were told conflicting stories about that night.

Theories include him being 'forcibly pushed from the bed of a moving truck' where the blood spot was, and staggering along the road before collapsing.

Presgrove could also have been killed in an accident or murdered elsewhere and his body dumped on the highway.

Initial belief that he was killed in a hit-and-run was ruled out based on the pattern of his injuries that didn't include any damage to his lower body.

Confronting photos of police chalk outlines showed his teeth were found scattered across the highway, some a dozen feet from his body.

Farther away still is a spot of blood - the only blood found at the scene despite the extensive injuries all over his upper body.

Confronting photos of police chalk outlines showed where his body, marked by the white line, and at least one of his teeth, marked by the circle, were found

Farther away still is a spot of blood - the only blood found at the scene despite the extensive injuries all over his upper body

The blood spot was dozens of feet away from the body, which is opposite the cross

Presgrove and his friends graduated from Comanche High School just a few months earlier and his family said he planned to join the military.

But that weekend they were drunkenly celebrating the end of summer with a raging party at the birthday girl's home, on a small street about a mile south from where his body was found, detailed in videos obtained by DailyMail.com. 

One video from the night he died showed some of Presgrove's friends writing their names on his bare buttocks with marker. 

The writing was not still there when his body was discovered in the early hours of the morning but it was not known how and when it was removed.

Other photos show the teenager writing on the buttocks of another friend, and posing alongside them with a signature on his chest.

Two more videos show Presgrove daring friends to slap him across the face as they partied under an outside patio at the house.

That weekend they were drunkenly celebrating the end of summer with a ranging party at the birthday girl's home

Presgrove (left) poses with a friend on the Sunday night of the party hours before his death

Presgrove's (left) family complained his friends all claimed to have no idea what happened to him and how he ended up dead by the roadside just hours later

Presgrove had to repeatedly insist that a male friend hit him, eventually only giving him a light tap before sprinting away in fear of retaliation.

Another concerning photo appeared to show a teenager holding a rifle with Presgrove visible in the foreground.

His family complained his friends all claimed to have no idea what happened to him and how he ended up dead by the roadside just hours later.

The Oklahoma State Bureau of Investigation described his death as 'suspicious' days later, but few details have been released about the investigation.

Even Presgrove's family said they were in the dark and the Oklahoma Highway Patrol refused to provide any details to maintain the 'integrity of the investigation'.

'The longer you keep the truth inside, the guiltier you become… you could aid in getting justice for Noah,' his sister Madison Rawlings said.

'You could do the right thing and may receive a mercy that was not given to him, but the longer we sit in silence, the worse it becomes for you.

'I hope those involved see that we are not budging and the silence fuels our desire to know more. 

'I miss Noah daily. This is the hardest chapter of my life, but I am thankful that I have a family that will not give up on each other.'

nd perseverance in finding answers.' The Oklahoma State Bureau of Investigation called Presgrove's death 'suspicious' in the days after his body was found

Presgrove's aunt Robyn Smith (center) and grandmother Deborah Smith (right) appealed for answers more than seven months after his death

Presgrove's grandmother Deborah Smith also called on his friends to tell the whole story about what happened the night he died.

'When you think you have friends that you trust with all your heart and then here it comes. Sorry Noah that some of your true friends stabbed you in the back,' she said.

'A piece of my heart is missing and every day that goes by and Noah doesn't walk through the door and still no answer just takes another piece of my heart.'

His aunt Robyn Smith begged anyone with information to at least tell the police so his family would have answers seven months later.

'We lost an amazing young man to the horrible choices of others, please do not let us lose out on justice,' she said.

'We’ve heard so many different stories, but we have yet to hear the truth. The whole truth. Which we deserve. 

'I know it’s scary and I know it’s hard, but we deserve to know what happened. Noah deserves to have his story told. We will not stop searching and asking. We will not stop demanding. It will come out.'