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Cuyahoga County, Ohio, USA. This individual committed suicide by intraoral gunshot wound to the head, no further info. Head injuries from shotguns and high-powered rifles are typically quite devastating, often with extensive soft tissue destruction, skull fractures, and pulpifaction of the brain. Occasionally, the brain is largely expelled from the cranial vault and may be found near the body. Self-inflicted submental and transoral wounds may produce serious but survivable brain injuries if the path of the bullet is limited to the frontal area.

Fig.1

Fig.2

The head is the most common location for a suicidal shotgun wound (74%), followed by the chest (20%) and then the abdomen (6%). In head wounds, the most common location was intraoral (50%), followed by under the chin (19%); side of head, including parietal and temporal wounds (15%); and the face, including the forehead (13%).

Fig.3

Fig.4

In the case of homicides, 59% occurred at a distant range, 21% occurred at an inter-mediate range, and 8% were at contact range. There was not a significant most common location for homicidal shotgun wounds, though the head, chest, and multiple locations all occurred about 25% of the time, representing the three most common locations. The most common locations of wounds to the head were face, including forehead (37%), and the side of the head, including parietal and temporal wounds (23%). (Molina et al. 2007).

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