Journal of Forensic and Legal Medicine 69 (2020) 101888

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Journal of Forensic and Legal Medicine

journal homepage: http://www.elsevier.com/locate/yjflm

Craniofacial injuries by firearms projectiles: An analysis of 868 deaths in

the five regions of Brazil
Talita Lima Castro-Espicalsky a, Sarah Teixeira Costa a, Bianca Marques Santiago b,
Alexandre Rodrigues Freire a, Eduardo Daruge Júnior c, Felippe Bevilacqua Prado a,
Ana Cl�audia Rossi a, *
a
Department of Morphology, Anatomy Division, School of Dentistry of Piracicaba, University of Campinas - UNICAMP, Brazil
b
Department of Clinics and Social Dentistry, Federal University of Paraíba, Jo~
ao Pessoa, Brazil
c
Department of Social Odontology, Forensic Dentistry Division, Piracicaba Dental School, University of Campinas - UNICAMP, Brazil

A R T I C L E I N F O A B S T R A C T

Keywords: Firearms injuries have a legal and medico-legal importance, and are especially lethal when they reach the
Gunshot wounds craniofacial regions of the victim. The present study aims to identify the characteristics of craniofacial lesions
Craniocerebral trauma resulting from firearm projectiles, to register the most affected craniofacial regions by this type of injury and to
Brazil
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
Jo~ao Pessoa, Vit�
oria, 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 investi­
gative conclusions based on the analyzes discussed in the present work.

1. Introduction
Firearms injuries have an important legal significance and constitute
a universal problem from the human, medical and economic perspec­
tives.1 Their incidence is different between countries and their charac­
teristics vary in several aspects,2 being especially lethal when they reach
the craniofacial regions of the victim.3
The medical-legal properties of this type of lesion such as shape, size
and distance of the shot, and especially its location, are points that need
to be studied because they are useful in determining the legal cause of
death and in establishing the circumstances of the aggression during
investigations criminal offenses.4
Despite its value, retrospective studies on the subject have shown
little detail in the registry of these aspects, especially regarding the
anatomical subdivisions of the craniofacial region2,5–12 and none were
reported in Brazil.
With the development of finite element analysis technology and its
application to forensic contexts, especially the study of the

* Corresponding author. Department of Biosciences, Anatomy Division, Piracicaba Dental School, University of Campinas - UNICAMP, 901 Limeira Avenue, Arei~
ao,
13414-903, Piracicaba, SP, Brazil.
E-mail address: anarossi@unicamp.br (A.C. Rossi).

https://doi.org/10.1016/j.jflm.2019.101888
Received 30 December 2018; Received in revised form 4 October 2019; Accepted 8 December 2019
Available online 10 December 2019
1752-928X/© 2019 Published by Elsevier Ltd.
T.L. Castro-Espicalsky et al.
biomechanical mechanisms of lesions in craniofacial regions,13–17 it is
necessary to know the characteristics of the injuries by firearm pro­
jectiles, in order to allow the comparison between the results obtained in
reality and those from the computational simulations being produced.
Thus, the aim of this study was to identify the characteristics of
craniofacial lesions resulting from firearm projectiles observed in ca­
davers necropsied in five medical-legal Institutes in Brazil, to register the
craniofacial regions most affected by this type of injury and to verify the
demographic profile of the victims involved.
2. Material and methods
The study was approved by the Research Ethics Committee (protocol
number: 66489717.9.0000.5418) from Piracicaba Dental School – State
University of Campinas (UNICAMP).
2.1. Sample
For the retrospective analysis proposed, a study was carried out on
necropsy registries of five Brazilian Legal Medicine Institutes, related to
corpses victims of firearm projectiles, necropsied in the period between
January 1 and June 30 of 2015. Legal Medicine Institute was selected
from each of the five geopolitical regions of Brazil in order to make the
sample as representative as possible, including in the study the institutes
of the following locations: Porto Velho, Rond^ onia (North Region); Jo~ ao
Pessoa, Paraíba (Northeast Region); Vito �ria, Espírito Santo (Southeast
Region); Porto Alegre, Rio Grande do Sul (South Region); and Brasília,
Federal District (Central-West Region) (Fig. 1).
2.2. Inclusion and exclusion criteria
The records included were referring to corpses of any sex and skin
color, aged between 12 and 80 years old at the time of death and pre­
senting at least one craniofacial lesion resulting from a firearm projec­
tile. The corpses which presented only infracranial injuries without
damage to the craniofacial region were excluded. The lesions in
craniofacial soft tissues without damage to the craniofacial bones, pro­
duced by projectiles that entered and left without touching the skull,
were excluded from the study. Injuries that reached large areas with no
exact definition of the affected region were also excluded from the study.
Fig. 1. Illustrative map with the five states of origin of the institutes: Porto Velho, Rond^
Espírito Santo (Southeast Region); Porto Alegre, Rio Grande do Sul (South Region); and Brasília, Federal District (Central-West Region).
2
Journal of Forensic and Legal Medicine 69 (2020) 101888
2.3. Data collection and statistical analysis
Data extracted from the selected reports included sex, age of the
victim, skin color, number of injuries (entrance and exit) from firearm
projectiles, craniofacial regions affected, shooting distance, shape and
size of injuries, and legal cause of injury. Death (homicide, suicide or
accident) recorded in the records analyzed. Illustrative charts suggested
in the Brazilian Legal Medicine Institutes to aid in the description of
bodily injuries were adapted for the standardization of the anatomical
regions (Fig. 2).
The information collected was submitted to descriptive statistical
analysis by the BioEstat® program (Mamirau� a Institute, Conservation in
the Amazon). The normality of the data related to the size of the lesion of
entrance and exit of the projectiles was evaluated by the D’Agostino-
Pearson test and the comparisons of the means were done by the Mann-
Whitney test. Values of probability <0.05 were considered significant.
3. Results
From the analysis of 5942 necropsy reports produced during the
study period in the five selected Legal Medicine Institutes, there were
1656 reports involving gunshots (27.9%). The reports that had at least
one lesion in craniofacial regions were selected and included in the
Fig. 2. Illustrative scheme showing the subdivision of the craniofacial regions.
The frequencies of the wounds of entrance in each region are listed in Table 3,
according to the numeration shown in the figure. Sub-divisions of the cranio­
facial regions: 1. Temporal; 2. Occipital; 3. Parietal; 4. Mandibular; 5. Frontal;
6. Orbital; 7. Oral; 8. Zigomatic; 9. Maxilla; 10. Nasal.
onia (North Region); Jo~
ao Pessoa, Paraíba (Northeast Region); Vit�
oria,
T.L. Castro-Espicalsky et al. Journal of Forensic and Legal Medicine 69 (2020) 101888

survey, totaling 868 reports submitted to data collection. 4. Discussion

We observed 1700 entrance injuries by firearm projectiles in
craniofacial regions, of which 830 transfixed the body and produced exit The retrospective and documentary study presented here represents
wound and 870 remained impacted or housed in cranial structures. an important and unprecedented information conference on the subject
About the profile of the victim, there was a higher frequency of in Brazil. The sample size selected for this study, which is composed of
victims among males (93.3%), aged between 12 and 29 years (59.4%) 868 reports, is considerably larger than the samples published in other
(Table 1). Regarding skin color, 62.0% (538) of the victims had mixed countries, according to Table 7. Firearm deaths accounted for 27.9% of
race, 27.0% (234) were white, and 6.7% (58) were identified as black, all necropsies performed at the Institutes of Forensic Medicine analyzed,
being absent in 4.3% (38) of the analyzed reports. For the categorization a much larger proportion than those found in other countries.
of the victims according to the color of the skin, the nomenclature Among craniofacial wounds of known legal cause, homicides
present in the reports was considered, according to the evaluation and constituted the majority of the sample, with 447 (97.0%) cases against
description made by the medical examiner responsible for the 13 (2.8%) of suicides. These proportions are similar to those found in
examination. some countries such as Turkey,9,18,19 Iran,2 India,10 USA,20 England21
Among cases of known legal cause, homicides constituted the ma­ and Egypt,11 but quite different from the data collected Sweden,22
jority of the sample, with 447 (97.0%) cases, against 13 (2.8%) of sui­ Italy,5,6 Denmark23 and Australia,24 which showed a predominance of
cides and one (0.2%) accident reported in the series studied. suicides in relation to homicides.
As for the number of projectiles that hit the body of each victim, Only one (0.2%) accident was found in the series of cases studied
considering injuries in any part of the body, it was found that in all cases here, also reported as less common in other studies.2,9,18,19,23 They may
considered as suicide or accident there was only one entry injury. In be related to unforeseen in hunting, as a result of domestic strife or
82.8% of the homicides multiple entries were observed, ranging from 2 unsafe gun manipulation practices, that may reach itself or others.6,19,22
to 59 wounds (Table 2). In Brazil, accidental shots caused by urban violence, classified as un­
The analysis of the location of the wounds (Fig. 2 and Table 3) identified motivational shots, popularly known as “lost bullets”, have
revealed that the region most affected by firearm projectiles was the become frequent. The constant police operations in “favelas” and com­
skull cap, represented by temporal bones (25.2%), occipital bones munities and their direct confrontation with armed criminals result in
(19.8%), parietal bones in addition to the mandibular region (10.6%). projectiles being fired in the communities and reaching people not
When considering the legal causes of death separately, it was observed involved in the conflict. According to a report published by the United
that the occipital region was not targeted in any case of accident or Nations in 201625, the Brazil is the country with the highest number of
suicide but was present in 22.2% of the homicides. In suicides, bilateral lost bullet deaths among Latin American and Caribbean countries.
temporal regions (76.9%) and intraoral region (23.1%) were the most Regarding the profile of the victims of this type of wound, the results
common targets; in the only reported accident between cases, the pro­ showed that mixed race men of productive age are the most frequent
jectile entered the right temporal region. victims of this type of injury. As in cases of violence-related deaths in
About the projectile exit regions (Table 4), the most common sites general, men appear in a larger proportion than women. According to
were temporal (25.3%), parietal (16.1%) and frontal (13.4%) regions. In Hagras and Kharoshah,11 young people tend to become more involved in
46.9% (407) of the cases, other craniofacial bones were fractured, in fights and more aggressive than older individuals. Likewise, men are
addition to those involved in the entrance and exit of the projectiles. generally more susceptible to tension and violence than women, who
It was possible to identify the distance of the shoot in 521 lesions avoid engaging in clashes that can generate physical disagreements.
(Table 5), of which 283 (54.3%) were by long distance shots, 185 In the present study, multiple entry wounds were observed in 79.7%
(35.5%) of short distance and 53 (10.2%) cases were related to contact (692) of the cases. In this analysis, we verified the total number of shots
shots. All cases of suicide were related to contact shots (69.2%) or short that reached the victim, considering the craniofacial lesions and added
distance shots (30.8%). The reported accident involved a contact shot to those present in the rest of the body.
case. Among the homicides in which this information was present, the In homicides, this rate was 82.8%, coinciding with the assertion that
injuries were produced by contact shots in 7.3% of the cases and at a several gunshot wounds in a single victim strongly suggest homi­
short distance in 38.7%, with more frequent shots at a distance range cide.4,5,29 The case of a man murdered by 59 gunshots distributed in
(54.0%). craniofacial and body regions on a public road was called attention,
The shape of the entry wound was recorded in 646 cases (Table 6) leading him to death on the spot. Long distance shots were common
and was mostly circular (56.8%) and oval (31.3%). When only the (54.3%) among homicides, also considered as suggestive of this type of
contact shots were analyzed, it was observed that the entry wound was death.5
irregular or starry in 20 of the 34 cases (58.8%). The contour of the exit All the cases of suicide and accident analyzed showed only one
lesions was described in only 245 cases and the most common form was wound at the entrance of the projectile, all produced with contact or
irregular (43.3%), followed by the starry one (24.1%). short distance shot, revealing characteristics common to this type of
The wound size was recorded as cited in the reports (Figs. 3 and 4) occurrence. Despite this, the literature shows reports of suicide with
and the mean of the extent of the inflicted injuries was 9.85 mm, smaller more than one shot,2,5,9,21–24,29–31 and this information is not enough to
than the ones with an average of 13.37 mm of extension (p < 0.0001, define the legal cause of death.
Test of Mann-Whitney). Several geometric forms were cited for the description of the shape of
the projectile entrance and exit injuries, with circular (56.8%) and oval
(31.3%) and irregular (43.3%) exit wounds being more common, coin­
Table 1 ciding with established by the literature, which states that the entrance
Distribution of age and sex of the victims. wounds tend to be round or oval and the most irregular or angular exit.28
Age Female Male Total The analysis of wound size revealed that the lesions were larger than
11–20 years 12 (20.7%) 226 (27.9%) 238 (27.4%) the entrance wounds (p < 0.0001, Mann Whittney Test), which can be
21–30 years 15 (25.9%) 284 (35.1%) 299 (34.4%) explained by the projectile dynamics that, after penetration into the
31–40 years 11 (19.0%) 165 (20.4%) 176 (20.3%)
41–50 years 11 (19.0%) 64 (7.9%) 75 (8.6%)
skull, velocity, undergoes deformation and acquires greater instability,
51–60 years 2 (3.4%) 34 (4.2%) 36 (4.1%) generating more extensive destruction in the exit region than in the
Over 61 years 3 (5.2%) 12 (1.5%) 15 (1.7%) entrance.28
No information 4 (6.9%) 25 (3.1%) 29 (3.3%) About the craniofacial regions targeted, although the skull cap was
Total 58 (100%) 810 (100%) 868 (100%)
mostly targeted (66.7%), the face was also very affected (27.4%) in both

3
T.L. Castro-Espicalsky et al. Journal of Forensic and Legal Medicine 69 (2020) 101888

Table 2
Number of entry injuries per victim, according to legal cause of death.
Number of entry injuries Legal cause of death Total
Accident Homicide Suicide Undefined
1 1 (100%) 77 (17.2%) 13 (100%) 85 (20.9%) 176 (20.3%)
2 44 (9.8%) 63 (15.5%) 107 (12.3%)
3 61 (13.6%) 63 (15.5%) 124 (14.3%)
4 59 (13.2%) 33 (8.1%) 92 (10.6%)
5 54 (12.1%) 35 (8.6%) 89 (10.3%)
6 32 (7.2%) 25 (6.1%) 57 (6.6%)
7–10 74 (16.6%) 59 (14.5%) 133 (15.3%)
11–15 26 (5.8%) 24 (5.9%) 50 (5.8%)
16–20 10 (2.2%) 13 (3.2%) 23 (2.6%)
21–25 8 (1.8%) 6 (1.5%) 14 (1.6%)
26 1 (0.2%) 1 (0.1%)
40 1 (0.2%) 1 (0.1%)
59 1 (0.2%) 1 (0.1%)
Total 1 (100%) 447 (100%) 13 (100%) 407 (100%) 868 (100%)

Table 3
Regions of entry of projectiles according to each legal cause of death.
Entry regions Legal cause of death Total

Homicide Suicide Accident Undefined

1. Temporal 229 (24.9%) 189 (24.7%) 429 (25.2%)

Left Temporal 117 (12.7%) 4 (30.8%) 96 (12.5%) 217 (12.8%)
Right Temporal 112 (12.2%) 6 (46.1%) 1 (100%) 93 (12.1%) 212 (12.5%)
2. Occipital 204 (22.2%) 133 (17.4%) 337 (19.8%)
3. Parietal 116 (12.6%) 100 (13.0%) 216 (12.7%)
Left Parietal 66 (7.2%) 46 (6.0%) 112 (6.6%)
Right Parietal 50 (5.4%) 54 (7.0%) 104 (6.1%)
4. Mandibular 92 (10.3%) 88 (11.5%) 180 (10.6%)
Right lateral region 43 (4.3%) 26 (3.4%) 69 (4.0%)
Left lateral region 32 (4.1%) 41 (5.3%) 73 (4.3%)
Mental region 16 (0.2%) 18 (2.3%) 34 (2.0%)
Undefinited 1 (10.0%) 3 (0.4%) 4 (0.2%)
5. Frontal 95 (4.7%) 57 (7.4%) 152 (8.9%)
6. Orbital 33 (3.5%) 40 (5.2%) 73 (4.3%)
Left 21 (1.7%) 22 (2.9%) 43 (2.5%)
Right 12 (0.1%) 18 (2.3%) 30 (1.8%)
7. Oral 40 (3.6%) 24 (3.1%) 67 (3.9%)
Oral (labial) 38 (2.3%) 22 (2.9%) 60 (3.5%)
Oral (intraoral) 2 (1.3%) 3 (23.1%) 2 (0.3%) 7 (0.4%)
8. Zigomatic 33 (3.6%) 33 (4.3%) 66 (3.9%)
Left 18 (2.0%) 19 (2.5%) 37 (2.2%)
Right 15 (1.7%) 14 (1.8%) 29 (1.7%)
9. Maxilla 23 (2.5%) 35 (4.6%) 58 (3.4%)
Right 12 (1.3%) 17 (2.2%) 29 (1.7%)
Left 11 (1.2%) 18 (2.3%) 29 (1.7%)
10. Nasal 7 (0.8%) 14 (1.8%) 21 (1.2%)
Other regionsa 48 (5.2%) 53 (6.9%) 101 (5.9%)
Total 920 (100%) 13 (100%) 1 (100%) 766 (100%) 1700 (100%)
a
Right Temporoparietal (16; 0.9%); Interparietal (10; 0.6%); Right Hemiface (8; 0.5%); Right Parietooccipital (8; 0.5%) and left (8; 0.5%); Skull basis (7; 0.4%); Left
Temporooccipital (7; 0.4%); Left Temporoparietal (7; 0.4%); Left Frontoparietal (6; 0.3%) and right (5; 0.3%); Left Hemiface (5; 0.3%); Left Frontotemporal (3; 0.2%)
and right (3; 0.2%); Median Parieto-occipital (3; 0.2%); Magnum foramen (2; 0.1%); Right Nasal-orbital (1; 0.1%); Right Temporomandibular (1; 0.1%) and left (1;
0.1%).

homicides and suicides, drawing attention due to association of facial
wounds with airway involvement and intracranial injuries, as well as
aesthetic and psychological damages to the victim who is not dead.32
The occipital region was very frequent among homicide cases
(22.2%), but was not reached in any case of suicide, due to the
improbable positioning of the weapon in this region in cases of self-
injury.5,24,26 The areas of suicide selection in the head have been re­
ported as the temporal and the mouth, compatible with several
works5,6,21,23 and possibly explained by the immediate devastating ef­
fects generated after shooting in these regions.4
These regions, however, were also reached in cases of homicides, and
the affected time in the only case of observed accident. According to the
literature, in the homicides there is greater variability between the
affected regions, with no preferred region. Oral lesions may exist, but
tend to be only incidental, usually with horizontal direction, and may
pass through the lip and tongue and often have characteristics of distant
shots. In suicides, the subject usually places the gun inside the mouth
intentionally, in an inferior-superior direction, injuring the palate or
pharynx, and it is possible to observe short-range shooting signals in the
region.4,7,8,33,34 Intraoral shots in homicides are infrequent5,7,8,21,23,26,35
and require careful evaluation.
It is important to note that the distinction between homicide, suicide
and accident can sometimes be extremely difficult and a final conclusion
can only be reached after a full police investigation. It is not enough to
consider only the location of the lesions,5,22 but it is necessary to gather
information from the necropsy, including the characteristic signs found
in the body and the path made by the projectile; of local expertise such
as the presence of a weapon at the body’s meeting place; of additional
expert examinations possibly carried out, such as the analysis of gun­
powder residue in the hands of the victim,36 the study of blood drop

4
T.L. Castro-Espicalsky et al. Journal of Forensic and Legal Medicine 69 (2020) 101888

Table 4
Craniofacial regions of exit of the projectiles.
Exit regions Frequence

Temporal 210 (25.3%)

Left 107 (12.9%)
Right 103 (12.4%)
Parietal 134 (16.1%) Table 6
Left 71 (8.5%) Shape of the wounds of entrance and exit.
Right 63 (7.6%)
Frontal 111 (13.4%) Shape of the wound Entrance Exit
Occipital 96 (11.6%) Elongated 0 (0%) 1 (0.1%)
Mandibular 76 (9.2%) Circular 367 (21.6%) 47 (5.7%)
Right lateral region 28 (3.4%) Conoid 1 (0.1%) 1 (0.1%)
Left lateral region 36 (4.3%) Eliptic 10 (0.6%) 3 (0.4%)
Mental region 12 (1.4%) Starry 17 (1.0%) 59 (7.1%)
Orbital 64 (7.7%) Fissure 0 (0%) 3 (0.4%)
Left 28 (3.4%) Irregular 48 (2.8%) 106 (12.8%)
Right 36 (4.3%) Oval 202 (11.9%) 25 (3.0%)
Maxilla 31 (3.7%) Uniform 1 (0.1%) 0 (0%)
Right 18 (2.2%) Undefined 1054 (62.0%) 585 (70.5%)
Left 13 (1.6%) Total 1700 (100.0%) 830a (100%)
Zigomatic 28 (3.4%)
a
Left 18 (2.2%) Only 830 projectiles transfixed the skull and produced exit wounds. The
Right 10 (1.2%) remaining 870 remained housed or impacted in cranial structures.
Oral 22 (2.6%)
Oral (perioral) 18 (2.2%)
Oral (intraoral) 4 (0.5%)
Nasal 17 (2.0%)
Skull base 9 (1.1%)
Other regionsa 32 (3.9%)
Total 830 (100%)
a
Left Frontotemporal (6; 0.7); Interparietal (5; 0.6%); Right Hemiface (3;
0.4%); Right Parieto-occipital (3; 0.4%); Right Temporo-occipital (3; 0.4%);
Right Temporoparietal (3; 0.4%); Right Frontoparietal (2; 0.2%); Left Fronto­
parietal (2; 0.2%); Right Frontotemporal (2; 0.2%); Right Fronto-orbital (1;
0.1%); Left Hemiface (1; 0.1%); Left Parieto-occipital (1; 0.1%).

patterns, the comparison of raiding and deformations of the projected

projectile, or the search for other signs of violence in the place and in the
body.
In 46.9% (407) of the cases, other craniofacial bones were fractured, Fig. 3. Size (cm) of the entrance gunshot wounds. X-axis: Wound size (cm); Y-
in addition to those involved in the entrance and exit of the projectiles. axis: Number of wounds.
This represents the significant morbidity caused during the transfer of
energy from the projectile to the craniofacial tissues, which causes
damage in neighboring regions or even distant from the projectile
path.37
One limitation was the lack of information related to the caliber of
the projectile and type of firearm in the evaluated medical-legal reports.
In Brazil, such information is not always available at the time of the
autopsy, because the murder weapon has not yet been identified by the
investigations and because the projectile is absent in many cases.
In Brazil, the information related to the type of weapon and the type
of firearm is not available in the medical-legal reports produced from the
autopsy of a body, which were the sample of this study. This type of
information is not always available at the time of the autopsy, as the
weapon of crime has not yet been identified by the investigations and
the projectile is missing in many cases. This also may be related to the
lack of communication between the Institutes of Legal Medicine and the
sectors of Forensic Ballistics, because the exchange of information be­ Fig. 4. Size (cm) of the exit gunshot wounds. X-axis: Wound size (cm); Y-axis:
tween these sectors is not common in Brazil. This hampers such data Number of wounds.

Table 5
Distance of the shot, considering the legal cause of death.
Shot distance Manner of death Total
Accident Homicide Suicide Not informed
Long Distance 148 (16.1%) 135 (17.6%) 283 (16.7%)
Short distance 106 (11.5%) 4 (30.8%) 75 (9.8%) 185 (10.9%)
Contact Shot 1 (100%) 20 (2.2%) 9 (69.2%) 23 (3.0%) 53 (3.1%)
Undefined 646 (70.2%) 533 (69.6%) 1179 (69.3%)
Total 1 (100%) 920 (100%) 13 (100%) 766 (100%) 1700 (100%)

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T.L. Castro-Espicalsky et al. Journal of Forensic and Legal Medicine 69 (2020) 101888

Table 7
Distribution of the manuscripts identified on the topic and data analyzed by each work.
Manuscript Country Sample Share of total Period Data analyzed
size necropsies
Victim’s Manner of Range Number Size and Craniofacial
age and sex death of fire entrance shape of regions
wounds wounds

Amiri et al. (2003)2 Iran 89 cases 0.83% 1 year Yes Yes Yes Yes No Little detailed
Azmak et al. Turkey 85 cases 17.0% 14 yeas Yes Yes Yes Yes No No
(1998)18
Cina et al. (1999)26 USA 120 – Nonconsecutive Yes Yes Yes Yes No Yes
cases
Desinan and Italy 48 cases – 11 years Yes Yes Yes Yes No Yes
Mazzolo (2005)5
Druid (1997)22 Sweden 288 – 10 years Yes Yes Yes Yes No Little detailed
cases
Edirisinghe and Sri Lanka 83 cases – 1 year Yes No No Yes No No
Kitulwatte
(2010)12
Fedaker et al. Turkey 495 14.3% 5 years Yes Yes Yes Yes No No
(2007)9 cases
Goren et al. Turkey 444 14.8% 6 years Yes Yes No No No No
(2003)19 cases
Hagras and Egipt 268 – 6 years Yes Yes No No No No
Kharoshah cases
(2012)11
Jeffery et al. Australia 211 1.8% 10 years Yes Yes Yes Yes No Little detailed
(2007)24 cases
Kumar et al. �India 66 cases 2.09% 2 years Yes Yes Yes Yes No No
(2015)10
Myint et al. Thailand 149 2.09% 10 years Yes Yes Yes Yes No No
(2014)27 cases
Quatrehomme and France 13 cases – Not informad No No No No Yes Yes
Iscan (1998)28
Rancic et al. (2013)1 Yugoslavia 120 – Nonconsecutive Yes No Yes No No No
cases
Rouse and Dunn England 128 – 11 years Yes Yes No Yes No Little detailed
(1992)21 cases
Thomsen and Denmark 276 – 4 years Yes Yes Yes No No Yes
Albrektsen cases
(1991)23
Verzeletti et al. It�
alia 164 2.9% 13 years Yes Yes No Yes No Little detailed
(2009)6 cases

from being inserted in the medical-legal reports. References

5. Conclusion 1. Rancic N, Erceg M, Radojevic N, Savic S. Medicolegal characteristics of firearm

In Brazil, homicides are responsible for most of the deaths caused by
firearm projectiles, with mostly male and mixed race victims, at a young
age. The projectile lesions of the projectiles are more frequent in the
temporal, occipital and parietal regions, caused by distant firing, and
show a circular or oval contour, with a smaller size than the exit wounds.
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.
Acknowledgements
The authors are thankful for the financial support granted by Coor­
dination for the Improvement of Higher Level or Education Personnel
(CAPES).
We acknowledge the Institutes of Legal Medicine of Porto Velho
(RO), Joa~o Pessoa (PB), Brasília (DF), Vito
�ria (ES) and Porto Alegre (RS),
for access to their archives.
We also acknowledge Mr. Marco Anto ^nio Cavallari Junior for the
final art of Fig. 1.
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