Forensic medical expert evaluation of gunshot injuries of brain skull

Forensic medical experts are offered a set of morphological signs which help identify the gunshot origin of a skull injury, identify which of the injuries is the inlet and which is the outlet, specify the direction of the shot and succession of formation of injuries in cases with several shots. The author suggests evaluating a gunshot wound in the head with due consideration for the mechanisms of its formation. From a complex of signs of a gunshot injury to the brain skull he singles out the tissue defect with a conical channel and the edge of bone defect, additional injury to the external compact plate near the inlet, and type, number, and location of the radial and concentric cracks. Analysis of the morphology of the above listed signs of gunshot injuries to the skull notable extends the potentialities of forensic medical expert evaluation in cases with gunshot injuries.     

枪弹创纤维蛋白形成能力的免疫组化研究

采用免疫组化PAP染色法，对57例人体枪弹创标本的纤维蛋白形成能力进行检测。结果发现，所有生前枪弹创均有纤维蛋白形成祖创缘邻近皮肤组织内毛细血管内皮细胞以及血管内充盈的红细胞膜上亦呈棕色阳性染色；死后30min内形成的枪弹创均有纤维蛋白形成；死后37min后形成的枪弹创无纤维蛋白形成，说明死后30min，纤维蛋白形成能力仍存在。作者认为，仅根据损伤局部有纤维蛋白形成即判断为生前伤是不恰当的，尚应结合损伤部位、损伤程度、损伤类型以及其它生活反应综合评定，不宜单凭纤维蛋白判断。     

Multiple gunshot wounds of the head: an anthropological view

A decomposed body was judged at the scene to have two gunshot wounds of the thorax and three of the head. Confirmed at autopsy, the condition of the remains precluded conclusions about the precise nature of the defects. Preparation and reconstruction of the skull disclosed seven large cranial defects and a series of fractures. This preparation allowed the application of well-known principles of gunshot wound analysis. Although the analysis of specific gunshot wound defects is well covered in the literature, there are few examples of the application of gunshot wound principles to complex wound cases. Three entrances and three exits were identified. A seventh defect resulted from bullet passage. Finally, the wounds were sequenced.     

Comparison of gunshot wounds and field-tipped arrow wounds using morphological criteria and chemical spot tests

Arrow wounds represent an unusual class of wounds rarely seen by most death investigators. Although the edged, broadhead-tipped arrow produces a wound usually characteristic of archery/crossbow weapons, the plain, field-tipped arrow wound can be confused with gunshot injuries in those cases in which powder residue or firearm projectiles or fragments or both are not recovered. We present a case of a deer carcass with a wound of uncertain firearm or archery origin which initiated a comparison of firearm wounds and archery wounds on fresh road-killed deer. We found the following features to be valuable in the differentiation of gunshot wounds and field-tipped archery wounds: First, the majority of the gunshot wounds (but none of the arrow wounds) had identifiable, macroscopic, wipe-off material and chemically identifiable wipe-off residue by spot test. Second, the archery wound defects had very inconspicuous abrasion rings as compared to the often prominent abrasion rings of gunshot wounds. Third, the actual central defect in the archery wounds was more likely to be oblong or slit-like compared to the gunshot wound defects, which were more likely to be round.     

The "inner gunshot residue"--a gunshot entry marker in gunshot of ridged skin]

Gunshot residue below the surface of the skin is typical of a contact gunshot wound. However, in a case of our own, when a taxi-robber was shot by the cab driver through his right hand at a distance of several yards, this finding provoked quite a confusion. Only when experimental shots at thick glabrous skin were performed, it could be established that long range shots led to intraepidermal gunshot deposit too. The explanation of this phenomenon lies in the tenacity of thick skin. Unlike the thin hairy skin, which is punched out by the penetrating projectile, the thicker and more tenacious plantar/palmar epidermis gets displaced radially, the stratum germinativum tears and the projectile casts its gunshot residue in the pouch formed in such a manner. Therefore, intraepidermal gunshot residue is proof of an entrance gunshot wound but not always a sign of contact shot if the wound is located in the palmar or plantar region. It is typically produced by shots at thick skin.     

Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

External beveling of cranial gunshot entrance wounds

Entrance gunshot wounds of the skull generally have internal beveling. External beveling has been previously described in association with internal beveling (keyhole defect) and with wounds from handgun projectiles. An accidental shooting is described in which a 22-year-old male sustained a perforating gunshot wound of the head at distant range from a 5.56-mm (.223-caliber) fully jacketed rifle round. Although the entrance wound had symmetrical external beveling, misinterpretation of this particular entrance wound as an exit wound would have been difficult.     

Two simultaneous suicidal gunshots to the head with robbed police guns

The suicidal infliction of two gunshot wounds to the head represents a critical issue for medicolegal investigation. In principle, simultaneous infliction with two firearms or third parties' involvement, i.e. two consecutive gunshots, have to be considered. We report for the first time on a case of suicidal infliction of two simultaneous gunshots to the head (oral, temporal) with Action 4 expanding ammunition. A male had robbed two service guns and committed suicide thereafter under the influence of high-dose alcohol and cocaine. Interestingly, Action 4 ammunition had been used, leading to an uncommon gunshot wound morphology and extensive backspatter. At the scene, these findings caused confusion; moreover, the number of gunshot wounds was unclear, until autopsy revealed two gunshot wounds to the head, which had obviously been inflicted simultaneously. Expanding ammunition like QD-PEP and Action 4, used by several German federal state police forces, can cause an atypical gunshot wound morphology, most probably due to its peculiar deformation behaviour. Investigators should be careful when interpreting gunshot wound morphology at the scene after usage of such expanding ammunition. With regard to reconstruction in cases of two gunshot wounds to the head and two guns at the scene, two simultaneous gunshots should be taken into consideration.     

利用颅骨枪弹创骨折类型推断射击方向和顺序的实验

建立利用颅骨枪弹创骨折类型推断射击方向和顺序的方法。使用国产五四式7．62mm口径手枪及五六式7．62mm口径半自动步枪,以3m的距离2次射击16具尸体的头颞部及枕部,造成颅脑贯通创,制成颅骨枪弹射入、出口各32例,并根据定位标记进行观察。结果显示：颅骨枪弹创骨折形态可分为带有斜面的孔状骨折,锁孔状骨折,放射状骨折和环状隆起骨折4种类型,其出现多见于低速枪射击,并与射击方向和顺序有直接关系。根据颅骨枪弹创骨折类型可推断射击方向和顺序。     

Effects of Decomposition on Gunshot Wound Characteristics: Under Cold Temperatures with No Insect Activity

Abstract:  Information on gunshot wound characteristics has been well documented; however, there is little documented information on the effects of decomposition or environmental conditions on gunshot wound characteristics. This study was conducted in order to determine if decomposition would obscure or alter the physical surface characteristics of gunshot wounds when exposed to a low temperature environment. The study was conducted from November 2005 to January 2006 in Nova Scotia, Canada in forested and exposed environments, with air temperatures between −10°C and +10°C. Pigs were used as human models and were shot six times each at three different ranges (contact, 2.5 cm, and 1.5 m). Gunshot wound characteristics persisted until the wounds were covered with ice and snow, after which changes were observed. The changes were recognized as being unique to the different ranges of gunshots and it was concluded that changes due to decomposition under the conditions tested would not affect the collection and interpretation of gunshot wound evidence.     

Morphological characteristics of gunshot wounds of liver and spleen

Stellate wounds are to be expected in gunshot injuries to the liver and spleen. As to their configuration, they resemble the skin breaks in an absolute close-range shot. The exit wound is larger than the entry wound. The genesis and utility of such injuries for reconstruction of the shot direction are discussed with reference to seven gunshot mortalities. Stellate wounds could also be achieved by shooting at isolated cadaver organs. The experimentally produced gunshot wounds differed from those produced in vivo in that the entry and exit wounds were equally large.     

A study of the morphology of gunshot entrance wounds, in connection with their dynamic creation, utilizing the "skin-skull-brain model"

The goal of this study was to document the dynamic effects created within, and the developing mechanisms of a gunshot entrance wound to the skin utilizing high-speed photography and the "skin-skull-brain model". The high-speed photography was taken with an Imacon 468/Hadland-Photonics camera. Full metal jacketed, 9 mm Luger projectiles were fired at the target model from a distance of 10 m. During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real gunshot entrance wounds. It has been possible to document and study the dynamic process of the "bullet-skin-interaction" in the gunshot entrance wound. The development of the morphologic terms of the entrance wound are discussed. In combination with high-speed photography, this "skin-skull-brain model" is a perfect tool for the documentation and the study of the dynamic development of gunshot entrance wounds in the skin.     

The mechanism of the formation of the bullet-entry gunshot damage to the bones of the cranial vault in shots from the TO3-10 small-bore 5.6-mm-caliber rifle

Data on experimental shots (3 series) from a TO3-10 small-gun that cause lesions of cranial vault bones are presented. It was stated that mechanism of formation of inlet bullet gunshot lesions of cranial vault bones involves several successive stages. Formation of gunshot lesion is affected by elastic bone properties and a "hydrodynamic effect".     

A case of internal beveling with an exit gunshot wound to the skull

Exit gunshot wounds of the skull generally have external beveling while entrance wounds show internal beveling. With rare exceptions, entrance gunshot wounds show external beveling, usually of two types: the asymmetric ‘keyhole’ type and the symmetric ‘non-keyhole’ type. In exit gunshot wounds of the skull, only the keyhole type has been reported. This report shows that symmetric internal beveling from an exit gunshot wound to the skull may confuse medical personnel.     

对纤维蛋白诊断生前伤的评价——45例枪弹创组织的MSB染色和扫描电镜对比观察

生活反应是诊断生前伤的主要根据.近二十年来,法医病理学在研究生前伤和死后伤的诊断中,采用了多种新兴技术,如扫描电镜技术、酶组织化学技术、酶标技术、电泳技术等,促使生前伤的诊断水平有明显提高.伤后存活1小时死亡者,大部分皆可获得明确诊断;立即死亡或在濒死期形成的损伤,由于生活反应甚微,或受腐败等     

扫描电子显微镜下生前和死后枪弹创的对比观察

本文用扫描电镜,对11例生前枪弹创和12例死后不同时间形成的枪弹创作对比观察。结果发现,生前枪弹创有大量红细胞和血小板凝块,纤维蛋白网形成,死后10min内的枪弹创亦有少许散在红细胞和纤维蛋白形成,很少见纤维蛋白网。死后25min的标本仍可见稀疏的红细胞,但无纤维蛋白形成。作者认为在扫描电镜下诊断生前枪弹创,需全面观察,综合分析。     

Mandibular fracture caused by absolute close-range gunshot with a blank cartridge fright weapon]

Bony injuries caused by starter's pistols were repeatedly observed in the form of fractures of the temporal squama and other thin osseous lamellae; in experiments rib fractures could also be produced. In the presented case a contact shot from a blank cartridge pistol caused a fracture of the lower jaw (transverse fracture with a bone fragment split off in reg. 46). The friend of the 17-year-old victim had fired a shot to the right mandibular region during an argument. In the depth of the gunshot entrance wound, which communicated with the oral cavity, intense soot deposits were found as signs of the contact shot.     

Postmortem Computed Tomography and Magnetic Resonance Imaging of Gunshot Wounds to the Neck

Postmortem magnetic resonance imaging (MRI) is rarely used for the radiologic assessment of gunshot injuries, although it has clear advantages over postmortem computed tomography (CT) with regard to the imaging of soft tissue injuries. Another benefit in using MRI is that lodged projectiles composed of nonferromagnetic material such as lead present only marginal metal artifacts compared with severe artifacts on CT. This case report presents CT and MRI findings in a case with two gunshot wounds to the neck: a perforating wound and a nonperforating wound with a lead bullet lodged in the cervical spine. The decedent underwent CT and MRI before the scheduled autopsy. A ring of radiopaque material under the dermis in the fatty tissue was identified at both entrance wounds on CT, which was indicative of contact shots. The perforating gunshot was clearly indicated on CT by bullet fragments along the wound channel through the perforated 6th cervical vertebra and the fractured cricoid cartilage at the exit wound. The second trajectory, however, was only assumed based on the presence of gunshot residues at the entrance wound and the position of the lodged bullet. The radiologic assessment was severely impeded by the metal artifacts on CT. Barely noticeable metal artifacts on MRI allowed for clear visualization of the soft tissue injuries and the ruptured medulla oblongata. Only MRI clarified the soft tissue injuries of the brainstem noninvasively, which could provide specific and graphic information on the rapidity of death and the incapacitation of the victim.     

Complex suicide by two gunshots to the chest and consecutive hanging: circumstances and aspects of reconstruction

In cases of suicidal gunshots, the capacity to act may be preserved for a certain period of time, so that the suicide may be completed with another method. In the presented case a 74-year-old man was found hanged on the first floor of his house with two gunshot wounds in the chest. Both on the ground and the upper floor traces of suicidal acts were detected. As shots to the precordial region suggest rapid incapacitation, a suicide extending over two floors seemed almost impossible without knowledge of the cause of death and evaluation of the ability to act. The autopsy findings confirmed vital signs of hanging. Moreover, a through-and-through gunshot wound of the chest and abdomen affecting the spleen and a shot lodged in the body without injuring the lung were found. The injury findings thus sufficiently explained the preserved ability to act. The presented case shows characteristics of a complex suicide not yet described so far, but could be clearly classified as suicide in congruity with the pertinent literature.     

A Rare Case of an Intact Bone Plug Associated with a Gunshot Exit Wound

This case study presents an unusual manifestation of gunshot trauma in skeletal tissue from a post‐World War II human rights abuse sample uncovered in Vilnius, Lithuania. After briefly reviewing the typical wound appearance of projectile trauma in the cranium, we discuss the presence of an intact bone plug associated with a gunshot exit wound in an individual from the Tuskulenai Case. While this individual demonstrated typical gunshot entry and exit wounds to the cranium consistent with high‐velocity trauma, the bone plug indicates that the projectile likely lost much of its kinetic energy while traveling through the cranium resulting in a low‐velocity impact at the exit site. This study reviews a similar instance of a bone plug recovered from a bioarcheological sample in Peru and emphasizes the importance of thorough archeological excavations of mass graves.