Forensic Pathology for Police - Brainshare Public Online Library

Miscellaneous Issues 363
wounds of the head will frequently have soot deposited on the dura matter and/or
bone that surrounds the skull entrance site (Disc Images 13.61 and 13.62). Another
useful finding in head gunshot wound cases involves the presence of skull bone
“beveling.” When a projectile strikes the skull, the side of the bone initially struck
by the bullet will typically have a relatively well-defined hole that approximates the
size and shape of the projectile. The opposite side of the skull will have a defect,
typically of the same shape, but of much wider diameter. The two sides of this skull
defect are connected by an angled, or beveled, surface of bone. The bone fragment
that is “punched out” resembles a cone shape. Entrance wounds, by definition, result
in skull bone defects that demonstrate “internal beveling” (the angled surface is evident
on the inside of the skull) (Figs. 13.37, 13.38, 13.39, and 13.40), whereas exit
wounds have skull defects with “external beveling.” Similar beveling can occur in
other relatively flat bones, such as ribs and the sternum. Tangential gunshot wounds
of the head can create a “keyhole” shaped defect, with internal beveling associated
with the round end of the keyhole shape, and external beveling associated with the
triangular end of the keyhole (Fig. 13.41). Gunshot wounds of the head can produce
basilar skull fractures, particularly in the front parts of the skull, just over the eyes,
causing hemorrhage around the eyes (“periorbital ecchymosis”) (Disc Image 13.63).
When describing the path of the gunshot wound, the pathologist should provide
an overall pathway with regard to three planes (front/back, right/left, and up
over/down). For example, the bullet traveled from front to back, from left to right,
and upward. Some pathologists prefer to estimate (or attempt to measure) the exact
angles in relation to these planes.
If projectiles are identified on internal examination, they will be collected as
evidence (Disc Images 13.64 and 13.65). In cases involving birdshot, only a representative
sample needs to be collected. In buckshot cases, an attempt should be
Fig. 13.37 An outer view of
a gunshot entrance wound of
the skull, after scalp reflection
(and after peeling away the
soft tissue normally adherent
to the outer surface of the
skull), showing absence of
beveling