In 2005 scientists from several universities and the General Hospital in Bolzano used modern x-ray technology to examine Oetzi's insides.
Analysis of those images revealed the severity of the arrowhead wound and allowed closer examination of some known cracks in his skull.
Previously researchers had concluded that the skull cracks resulted from natural changes to the corpse as it froze.
"Now they also detect some alterations of the brain which are still prevalent there, and it looks like it was more like an injury," Zink said.
Frank Rühli of the Institute of Anatomy at the University of Zurich in Switzerland led the research on the arrowhead wound published in the Journal of Archaeological Science and reported in the July 2007 issue of National Geographic magazine.
(National Geographic News and National Geographic magazine are parts of the National Geographic Society.)
Rühli agrees with the new analysis showing head trauma, but emphasized that the blow to the head was secondary to the fatal arrowhead wound.
"If the artery starts bleeding, it's a matter of minutes to die, [while] the trauma to the head is maybe a major trauma but it doesn't kill you instantly," Rühli said.
Zink, of the Institute for Mummies and the Iceman, noted that the arrowhead and head trauma evidence still fail to reveal the sequence of events that led to the iceman's end.
But a probable scenario is that Oetzi was first struck by the arrow and then struck in the head, or that he hit his head on rocks when he fell.
Not a Working Man
Katharina Hersel is a spokesperson for the Italian iceman institute. She added that scientists have long tried to determine why Oetzi was found face down with his left arm across his chest.
Zink's colleagues believe Oetzi was turned over onto his stomach by his attacker to remove the arrow shaft.
Only the arrowhead remained lodged in his shoulder.
Another suggested theory was that the shifting glacier moved his body. But the recent x-rays showed that Oetzi's skin is still intact.
"So this position was not made by the glacier, because if you turn around Oetzi when you have rigor mortis or if he is frozen, you break the skin," Hersel said.
In addition, Zink added, blood filled the hole left by the removed arrow shaft, which is further evidence that the body died in the position in which it was found.
The researchers at Monday's briefing also presented new details suggesting Oetzi was not accustomed to manual labor.
For example, his leg and foot bones show the wear and tear of an active walker, but his arms were not those of a working man.
He also wore a striped goatskin shirt that researchers believe is associated with the upper classes, and he carried high-value artifacts like an axe and a knife.
Oddly, Zink noted, whoever killed Oetzi decided to leave these artifacts.
"The [cause] of his death is quite clear now," he said, "but we don't know why it happened, why he was shot with this arrow, and why all his belongings remained there."
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