title: Chasing the casing: a 38 Special suicide.
abstract: Multiple self-inflicted gunshot wounds of the head are uncommon. Detailed history, scene investigation, autopsy findings, consideration of ballistics, and evidentiary proceedings are necessary to determine the manner of death in these cases. This report involves a pattern of atypical, self-inflicted bullet wounds of the head of a 26-year-old male. Investigation confirmed that a single eyewitness and several earwitnesses reported a single discharge of a firearm. The eyewitness testified that the decedent singly discharged a Smith & Wesson revolver, caliber .38 Special, to the right side of his head after interposing several objects between the muzzle and his skin immediately prior to discharge. He was declared brain dead two days later. At necropsy two contiguous atypical entry wounds were present in the right preauricular temple. The inferior wound was interpreted to be a near contact wound. The gray metal slug fragmented, creating separate tracks to the right maxillary sinus and the mid left posterior cerebrum, respectively. The larger, atypical wound of entry was associated with passage of the projectile through the right temporalis muscle and squamous temporal bone. The projectile, consisting of a slightly distorted empty metallic cartridge case containing a "live" primer, was recovered from its point of final lodgment in the right temporal lobe. The literature addressing paired entry wounds following single discharge of the firearm with interposed targets is relatively sparse. Cases reporting multiple bullet wounds involving suicide are only sporadically reported. This report summarizes the investigative findings supporting the determination of the manner of death and revealing the interesting origin of the "misplaced" casing.
authors: Office of the Associate Chief Medical Examiner, Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Frankfort, USA.
authors: D M
authors: DM
authors: Skinker
authors: C M
authors: CM
authors: Coyne
authors: C
authors: C
authors: Lanham
authors: J C
authors: JC
authors: Hunsaker
mesh_terms: D000328:Adult; D001929:Brain Edema / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D005389:Firearms; D005554:Forensic Medicine / Q000379:methods*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis*; D012886:Skull / Q000293:injuries*; D013405:Suicide; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000175:diagnosis*