Fenestration

The stars punched through the skull were not wounds. They were apertures — the skull making itself permeable to whatever was pressing from inside to get out. By the middle of the piece the pressing had resolved into tears, which is one way the interior finds its exit when the more direct routes are unavailable. By the end the apertures were gone and she was laughing, which may mean the release had been successful or may mean the image had simply moved on. The two possibilities are not distinguishable from the outside.