Traumatic brain injury secundary to atipical gunshot-wound. A case report

Abstract

Introduction: Traumatic brain injury secondary to gunshot wounds (HPAF) is a critical situation. The projectile of a firearm can penetrate the body through any region, causing lesions of varied morphology due to multiple factors. The place of entry of the projectile (orifice) may have small diameters, which escapes the observation of the attending physician, in these circumstances radiological techniques are essential as a diagnosis and a preliminary step to the judicial autopsy. Methodology: A review and analysis of the bibliography on Traumatic brain injury caused by firearms was carried out, it was possible to identify orifices or entry wounds through natural orifices or other regions of the body, not because of unusual locations as in this case, being necessary to carry out tomographic studies to locate the projectile, which allowed to have it as a reference in future cases.  Conclusions: The victim presented injuries, with severe head trauma. The tomography showed the presence of an intracerebral foreign body, similar to a projectile. The wound consisted of an atypical entrance orifice, in an unusual anatomical region, and a trajectory. At necropsy, the bullet was removed. The ballistics analysis revealed that it was a 22 caliber, of non-industrial manufacture, used in an atypical and improvised weapon. The intracranial injuries were severe, which by a direct mechanism caused the death of the injured person. The case was closed as a homicide.