Anatomic Pathology: Forensic Pathology

1158) How would the lesion depicted in the photograph aid the pathologist?

• The lesion of the calvaria represents an entrance gunshot wound of the skull cap with multiple associated radiating fractures.

• If only skeletal remains are located, this trajectory analysis may help in the investigation of the case.

• When a projectile enters a flat bone such as a skull bone, the outer table defect is smaller in diameter than the inner table defect owing to the presence of internal (or inward) beveling of the bone similar to the appearance of beveled glass. As the projectile pushes through the bone to exit through the inner table, small fragments of the medullary bone and splinters of the inner table cortical bone fragment create the larger diameter of the inner surface.

• The opposite phenomenon is true for a projectile exiting the cranial vault when the projectile encounters the inner table first and subsequently exits the skull through the outer table of the bone. In this scenario, the inner table defect diameter would be smaller than the outer table defect diameter, and the defect would be associated with external (or outward) beveling of the bone similar to the appearance of beveled glass.

DiMaio VJM: Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques. Boca Raton: CRC Press, 1999.

Spitz WU: Injury by gunfire.In Spitz WU (ed): Spitz and Fisher’s Medicolegal Investigation of Death. Springfield, StateIL: Charles C Thomas, 1993, pp 311-412.

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