Research Day
AROUND THE WORLD: A SHORT CASE SERIES OF ATYPICAL INTRACRANIAL BULLET TRACKS
Document Type
Abstract
Date
2021
Abstract
Introduction: Perforating gunshot wounds (GSWs) of the head occur when a bullet travels all the way through the head, whereas penetrating GSWs occur when a bullet does not exit. In such scenarios, the bullet pathway is typically linear, in a straight line. We present two cases where, upon perforating the cranium, projectiles traveled along the inside curvature of the cranial vault, coming to rest on the inner opposite side of the vault, without having traversed the brain.
Case Descriptions: Case 1: A 19-year-old sustained multiple lethal GSWs. Imaging revealed a bullet within the right cranium. At autopsy, the GSW entered the left temporal region and traveled around the anterior inner table of the skull, stopping within the superficial right occipital lobe. Case 2: A 42-year-old was found dead from a suicidal gunshot wound of his submental chin. Imaging revealed a bullet within the right cranium. Autopsy revealed the bullet entered the cranial vault via the left anterior cranial fossa, and then traveled along the inner contour of the skull before stopping within the right superficial parietal lobe.
Discussion: Although most GSW projectiles travel along a relatively straight pathway within the body, including the brain, the presented cases demonstrate that bullets may travel in an arc-like trajectory along the inner contour of the skull and be recovered on the opposite side of the brain. Such a trajectory might help to explain a clinical scenario where neurologic deficits are not as pronounced as one might expect.