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Italy. When a 38-year-old policeman did not arrive at work and could not be reached by telephone, two colleagues suspected an accident and entered his house opening the door with a spare key. In the bedroom, they found the man lying lifeless on the right part of the bed in a supine position and the corpse of his 50-year-old wife resting in a lateral position on the left part of the bed. Due to the presence of hypostasis and rigor mortis on both bodies, no resuscitation attempts were made and the death scene remained unchanged until the arrival of the scientific police and the medico-legal expert.

Fig.1 Death scene at the arrival of the police; the man lying lifeless on the bed in a supine position, and his 50-year-old wife resting in a lateral position on the bed. In the box: self-loading Glock pistol, mod. 17 Austria 5180, cal. 9 mm, found between the two corpses near the left forearm of the man, with the upper part of the barrel placed upon the bed.

A self-loading Glock pistol, mod. 17 Austria 5180, cal. 9 mm, was found between the two corpses near the left forearm of the man, with the upper part of the barrel placed upon the bed. On the floor, at the right side of the bed, a single brass-colored cartridge case (‘‘9 mm x 21 CBC’’) of a full metal jacket ammunition was identified and collected. Police investigations highlighted that, since a couple of months, the woman had started an extramarital relationship with a colleague. The husband discovered this relationship two weeks before the incident and the same day of the murder he wrote a telephone message to his wife’s lover saying ‘‘I’ll never let you take her away from me’’.

Fig.2 Here we observe the two skulls from the bottom of the bed, with the female’s head laying on the pillow with the left cheek and the male victim bending over her (probable shooting position).

Fig.3 Reconstruction of the most probable position of the two bodies.

In the man’s right anterior temporal region, a 1.7 cm wide irregularly round-shaped skin defect with blackened margins was observed. Beneath the skin and subcutaneous lesions, in the temporal fossa, a 2.2 cm wide round bone defect with internal bevelling and numerous bone fragments were identified. In the skullcap surrounding the entrance wound radial and circular fractures were found, some of which running through the bony skull base; the sagittal suture showed a significant diastasis. Along the bullet track, with right-left, down-up, and anteroposterior direction, metal fragments were both radiologically and macroscopically visible. In the left parietal bone, a 2.5 cm round bone defect with cone-shape external bevelling and extra-cranial bone fragments was detected. At the skin level, a 1.4 cm wide round-shaped lacerated wound with everted margins was present.

Fig.4 Male victim: Entrance wound and exit wound at inspection. 3D-CT reconstruction of the entrance wound and exit wound.

Fig.5 Female victim: Entrance wound at inspection.

In the woman’s right temporal region, a 1.3 cm wide round-shaped skin defect and a 2.2 cm wide round bone defect with internal bevelling and numerous bone fragments (both intra- and extra-cranially) were identified. Along the bullet track (with posteroanterior and right-left direction) metal fragments (two of which of 1 cm in diameter) were visible; in the sphenoidal sinus, beneath the central portion of the sella turcica, a highly deformed jacketed bullet was detected. A screening on blood and urine excluded the presence of alcohol, drugs of abuse, and medicines in both victims.

The man had leaned over the female while in bed and aligned his head with her head before taking the shot. After firing a single bullet that traveled through his head and into the female’s head, the man’s body fell back towards the bed, and the gun fell between the two bodies.

Fig.6 Female victim: 3D-CT reconstruction of the entrance wound and a reconstruction evidencing a deformed jacketed bullet in the sphenoidal sinus, beneath the central portion of the sella turcica. Bullet track at neuropathological examination.

Homicide–suicide incidents are rare events, making up a relatively small proportion of homicides overall. Interdisciplinary cooperation between police investigators, crime lab representatives, and forensic pathologists is recommended for differentiating double homicide from double suicide or murder-suicide, and for reconstructing the most probable dynamics of the event. As a matter of fact, in firearm-related murder-suicide cases, the contribution of ballistic experts and forensic radiologists can be pivotal.

In this case, prior to forensic autopsy, on both corpses, a whole-body multi-slice post-mortem CT was performed and provided precious information to differentiate the entrance wounds from the single exit lesion on the man’s skull, localize the retained bullet in the female’s skull, reconstruct the wound track direction, and hypothesize the most probable relative position of the bodies when the shot was fired.

Autoptic and histological findings determined that the murderer died immediately after the shot for a lethal brainstem injury, whereas the female victim survived for a few minutes after the shot.

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