Arc-like curvilinear bullet pathways along inner surface of skull - two cases.

Abstract

To provide example cases within the peer-reviewed literature of a phenomenon related to certain gunshot wounds of the head where the bullet pathway courses along the inner table of the skull. Presentation of two cases discovered at medicolegal autopsy. The two cases provide radiologic and autopsy demonstration of bullet pathways within the head where the projectiles track along the inner aspect of the cranium, in a circumferential manner, such that the bullets are recovered in a location on the opposite side of the brain/head, with no projectile pathway within the intervening deep structures of the brain. The cases provide photographic and radiologic autopsy documentation of the phenomenon, which is described in forensic pathology textbooks and rare peer-reviewed literature sources, but without photographic demonstration. Recognition of this phenomenon in the clinical setting, or when correlating autopsy external and radiologic findings with historical information, may provide an explanation for situations where immediate incapacitation does not occur following a gunshot wound of the head.