Cranial gun shot injuries are a form of penetrating traumatic brain injuries, which are much less common than blunt traumatic brain injuries.
Please see the main article "imaging of gun shot injuries" for a general description of imaging features.
The entry and exit wounds can be identified paying attention to the bone “beveling”. An inward beveling of the inner skull table is supportive of the entry wound, whereas the outward beveling of outer skull table suggests the exit wound. Often there is not an exit wound, especially in incomplete metal jacket bullets (e.g. hollow point tip) that are designed to fragment and lose kinetic energy along their path 1.
Treatment and prognosis
Unsurprisingly, mortality is high. In civilian shootings, approximately 20% survive the initial injury, and of those ~50% (range 30-68%) survive 2.
- 1. Forensic Sci Int. 2003 Dec 17;138(1-3):8-16. Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography and magnetic resonance imaging and subsequent correlation between radiology and autopsy findings.
- 2. Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment,Third Edition. CRC Press. ISBN:1466594802. Read it at Google Books - Find it at Amazon
- 3. Wilson AJ. Gunshot injuries: what does a radiologist need to know?. Radiographics. 1999;19 (5): 1358-68. doi:10.1148/radiographics.19.5.g99se171358 - Pubmed citation