Craniofacial injuries by firearms projectiles: An analysis of 868 deaths in the five regions of Brazil

• Published in: Journal of forensic and legal medicine Vol. 69; p. 101888
• Main Authors: Castro-Espicalsky, Talita Lima, Costa, Sarah Teixeira, Santiago, Bianca Marques, Freire, Alexandre Rodrigues, Daruge Júnior, Eduardo, Prado, Felippe Bevilacqua, Rossi, Ana Cláudia
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2020
• Subjects: Accidents - mortality; Adolescent; Adult; Age Distribution; Brazil; Brazil - epidemiology; Child; Continental Population Groups - statistics & numerical data; Craniocerebral trauma; Crime Victims - statistics & numerical data; Facial Injuries - mortality; Female; Gunshot wounds; Head Injuries, Penetrating - mortality; Homicide - statistics & numerical data; Humans; Male; Middle Aged; Retrospective Studies; Sex Distribution; Suicide, Completed - statistics & numerical data; Wounds, Gunshot - mortality; Young Adult; Brazil; Brazil; Craniocerebral trauma; Gunshot wounds
• DOI: 10.1016/j.jflm.2019.101888
• EISSN: 1878-7487
• ISSN: 1752-928X

Firearms injuries have a legal and medico-legal importance, and are especially lethal when they reach the craniofacial regions of the victim. The present study aims to identify the characteristics of craniofacial lesions resulting from firearm projectiles, to register the most affected craniofacial regions by this type of injury and to verify the demographic profile of the victims. A retrospective study was carried out on the autopsy records produced in the first semester of 2015, in five Institutes of Legal Medicine in Porto Velho, situated in the cities of João Pessoa, Vitória, Porto Alegre and Brasília. Data extracted included sex, skin color and age of the victim, craniofacial region reached, shooting distance, shape and size of the injuries and manner of death (homicide, suicide or accident). Based on the 868 reports analyzed, it was possible to observe 1700 entrance lesions of firearm projectiles in craniofacial regions. Among cases of known manner of death, homicides were the most frequent (97.0%). It was observed a higher frequency of male victims (93.3%), mixed race (62.0%), between the ages of 12 and 29 years (59.4%). In all cases considered as suicide or accident there was only one entrance wound, but in 82.8% of the homicides there were multiple gunshot wounds. The craniofacial most affected regions were temporal (25.2%) and occipital (19.8%). The most common sites of projectiles exit were the temporal (25.3%) and parietal (16.1%). All cases of suicide were related to contact shot (69.2%) or close-range shot (30.8%), and among the homicides the distant range shots were more frequent (54.0%). The shape of entrance wounds was mostly circular (56.8%) and oval (31.3%), and among the exit injuries, the lesions were irregular (43.3%) and starry (24.1%). The entrance wounds showed smaller sizes than the exit lesions (p < 0.0001). The data obtained are useful for guiding research that takes into account craniofacial trauma caused by firearm projectiles, makes it possible to compare this data with those of other countries and can base investigative conclusions based on the analyzes discussed in the present work.
•In Brazil, homicides are responsible for the deaths caused by firearm projectiles.•The most frequent victims are male and mixed race victims, at a young age.•The craniofacial most affected regions were temporal and occipital.•To assist in solution of homicide cases, improvements in the medical-legal reports are required.