title: 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.
abstract: 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.
authors.affiliation: Cook County Medical Examiner's Office, 2121 West Harrison Street, Chicago, IL, 60612.
authors.forename: Ponni
authors.initials: P
authors.lastname: Arunkumar
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopedics, "Sapienza" University of Rome, Viale Regina Elena, 336, Rome, Italy.
authors.forename: Aniello
authors.initials: A
authors.lastname: Maiese
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopedics, "Sapienza" University of Rome, Viale Regina Elena, 336, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bolino
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopedics, "Sapienza" University of Rome, Viale Regina Elena, 336, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gitto
mesh_terms: D000368:Aged; D001364:Awareness; D003334:Coroners and Medical Examiners; D020197:Head Injuries, Penetrating / Q000473:pathology*; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D013405:Suicide; D014836:Volition; D014948:Wounds, Gunshot / Q000473:pathology*
keywords: ability to act; firearms; forensic science; homicide; multiple gunshot wounds to the head; suicide