Suicidal Single Gunshot Injury to the Head: Differences in Site of Entrance Wound and Direction of the Bullet Path Between Right- and Left-Handed—An Autopsy Study

AbstractThe aim of this study was to determine the differences in the anatomical site of a gunshot entrance wound and the direction of the bullet path between right- and left-handed subjects who committed a suicide by a single gunshot injury to the head. The retrospective autopsy study was performed for a 10-year period, and it included selected cases of single suicidal gunshot head injury, committed by handguns. We considered only contact or near-contact wounds. The sample included 479 deceased, with average age 47.1 ± 19.1 years (range, 12–89 years): 432 males and 47 females, with 317 right-handed, 25 left-handed, and 137 subjects with unknown dominant hand. In our observed sample, most cases involved the right temple as the site of entrance gunshot wound (about 67%), followed by the mouth (16%), forehead (7%), left temple (6%), submental (2%), and parietal region (1%). The left temple, right temple, and forehead were the sites of the gunshot entrance wounds, which were the best predictors of the handedness of the deceased (Spearman &rgr; = 0.149, P = 0.006). Our study showed that the direction of the bullet intracranial path in cases of suicide was even a more potent predictor of the handedness of the deceased (Spearman &rgr; = 0.263, P = 0.000; Wald = 149.503, P = 0.000).

[1]  Jaakko Kaprio,et al.  Origins of handedness: A nationwide study of 30161 adults , 2009, Neuropsychologia.

[2]  R. Blumenthal Suicidal Gunshot Wounds to the Head: A Retrospective Review of 406 Cases , 2007, The American journal of forensic medicine and pathology.

[3]  V. Dimaio,et al.  Shotgun Wounds: A Review of Range and Location as Pertaining to Manner of Death , 2007, The American journal of forensic medicine and pathology.

[4]  B. Solarino,et al.  Fatal firearm wounds: a retrospective study in Bari (Italy) between 1988 and 2003. , 2007, Forensic science international.

[5]  Stian Reimers,et al.  Hand preference for writing and associations with selected demographic and behavioral variables in 255,100 subjects: The BBC internet study , 2006, Brain and Cognition.

[6]  G. Altun Planned complex suicide: report of three cases. , 2006, Forensic science international.

[7]  A. Munnich,et al.  Discontinuity in the fall of left-handedness in a French population: A May '68 effect? , 2006, Laterality.

[8]  C. Ciallella,et al.  Suicide With Two Guns Represents a Special Type of Combined Suicide , 2002, The American journal of forensic medicine and pathology.

[9]  B. Brinkmann,et al.  Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries , 2002, International Journal of Legal Medicine.

[10]  A. Schmeling,et al.  Female suicides in Berlin with the use of firearms. , 2001, Forensic science international.

[11]  V. Dimaio,et al.  Suicide by Firearms: A 15-year Experience , 2001, The American journal of forensic medicine and pathology.

[12]  K A Collins,et al.  Suicide: a ten-year retrospective study. , 2000, Journal of forensic sciences.

[13]  J. Weiner,et al.  Multiple self-inflicted gunshot wounds to the head: report of a case and review of the literature. , 2000, The American journal of forensic medicine and pathology.

[14]  A. Ozaslan,et al.  Intra- and perioral shooting fatalities. , 1999, Forensic science international.

[15]  T. Karlsson Multivariate analysis ('forensiometrics')--a new tool in forensic medicine. Differentiation between firearm-related homicides and suicides. , 1999, Forensic science international.

[16]  M L Taff,et al.  Planned complex suicide. , 1998, The American journal of forensic medicine and pathology.

[17]  J. Tobin,et al.  Three unusual cases of multiple suicidal gunshot wounds to the head. , 1998, The American journal of forensic medicine and pathology.

[18]  H. Druid Site of entrance wound and direction of bullet path in firearm fatalities as indicators of homicide versus suicide. , 1997, Forensic science international.

[19]  Donald F. Teal,et al.  Gunshot wounds : practical aspects of firearms ballistics, and forensic techniques , 1994 .

[20]  I. C. Stone Characteristics of Firearms and Gunshot Wounds as Markers of Suicide , 1992, The American journal of forensic medicine and pathology.

[21]  B. Jacob,et al.  Multiple Suicidal Gunshots to the Head , 1989, The American journal of forensic medicine and pathology.

[22]  J. Smialek,et al.  Suicide from Multiple Gunshot Wounds , 1989, The American journal of forensic medicine and pathology.

[23]  J. Smialek,et al.  The “Mini‐Packer” Syndrome: Fatal Ingestion of Drug Containers in Baltimore, Maryland , 1989, The American journal of forensic medicine and pathology.

[24]  J. Eisele,et al.  Sites of suicidal gunshot wounds. , 1981, Journal of forensic sciences.

[25]  B. Knight Forensic problems in practice. XII. Injuries from fire-arms and explosives. , 1976, The Practitioner.

[26]  J. Hansen Fatalities from firearms in denmark. , 1974, Forensic science.

[27]  Russell S. Fisher,et al.  Spitz and Fisher's Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation , 2005 .