Multifactorial Analysis of Firearm Wounds to the Head With Attention to Anatomic Location

Abstract

Firearm wounds to the head are often fatal and are routinely encountered in the practice of forensic pathology in the United States. Often, the anatomic site of the entrance wound is used to support or refute the manner of death indicated by the scene investigation and/or circumstances of the case. The present retrospective study of 120 fatalities resulting from 140 firearm wounds to the head correlates the anatomic region of the entrance wound and range of fire with the manner of death. Other demographic data analyzed include age, race, and gender of the decedents, as well as evidence of drug and/or ethanol use. It is hoped that this study will provide concrete data to support the largely anecdotal associations between the specific site of entry of firearm injuries to the head and the manner of death.

Fatal firearm wounds: A retrospective study in Bari (Italy) between 1988 and 2003

“…With regard to entrance wound distribution in suicides, this study confirms the presence of a typical area of the head that is strictly related to the use of a handgun [16,32], although the incidence in this sample (67%) is slightly lower than in other reports [7,12,15,16,24,27]. There is a high percentage of abdominal wounds (nearly 7%), which is in line with the percentage verified by Chapman and Milroy [8], but decidedly greater than in other reports (e.g.…”

“…Five of these homicides resulted in 18 entrance wounds, and one involved 30 entrance wounds sustained in the murder of a gang boss, where three guns were involved. Handguns were the most frequently used weapon (54%) in suicides as well as homicides [15][16][17] with the most common calibres being 7.65 mm (22.5%) and 9 mm (18.2%) pistols.…”

A case of hunting death due to an overpenetrated bullet

“…The intrasomatic bullet direction that was detected by CT scanning has been reported by previous authors in both suicide and homicide circumstances [3][4][5][6][7]. In addition, the paucity and the heterogeneity of the data in literature on accidental shooting [14][15][16][17][18][19][20] failed to add any convincing information to aid the reconstruction.…”

Sudden natural death in a suicide attempt

“…The history of chronic debilitating illnesses, such as strokes and hypertension, combined with clinical depression, promote suicidal tendencies in some elders who do not have the resources to properly manage the adverse situation. Firearm injuries are the most common method of suicide in the United States, and the head is the most favored site of injury, however, despite the initial investigation report, the forehead flesh wound in this case made the true nature of the victim's COD less apparent until the autopsy was completed (17,(22)(23)(24)(25)(26)(27).…”