title: An unusual lethal gunshot wound to the head.
abstract: Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.
authors.affiliation: 1 Department of Forensic Pathology, Institute of Legal Medicine, Tirana, Albania.
authors.forename: Elmas
authors.initials: E
authors.lastname: Shaqiri
authors.affiliation: 1 Department of Forensic Pathology, Institute of Legal Medicine, Tirana, Albania.
authors.forename: Bledar
authors.initials: B
authors.lastname: Xhemali
authors.affiliation: 1 Department of Forensic Pathology, Institute of Legal Medicine, Tirana, Albania.
authors.forename: Zija
authors.initials: Z
authors.lastname: Ismaili
authors.affiliation: 1 Department of Forensic Pathology, Institute of Legal Medicine, Tirana, Albania.
authors.forename: Admir
authors.initials: A
authors.lastname: Sinamati
authors.affiliation: 2 Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania.
authors.forename: Gentian
authors.initials: G
authors.lastname: Vyshka
mesh_terms: D000328:Adult; D006259:Craniocerebral Trauma / Q000401:mortality* / Q000473:pathology*; D005554:Forensic Medicine / Q000379:methods; D006801:Humans; D008297:Male; D014948:Wounds, Gunshot / Q000150:complications* / Q000401:mortality
keywords: Gunshot injuries; atypical wounds; crime scene investigation; destabilized bullets