Michael U. Antonucci, MD
Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0210.
Computed tomography images from 3 victims of gun violence.
Left. A young patient shot in the right temple. Noncontrast computed tomography shows minimal skin swelling near the entry site (A; arrow) with extensive ballistic and skull fragments in the underlying right temporal lobe. No exit wound was seen on examination, and the bullet stopped along the contralateral inner table (B; arrowhead), with resultant parenchymal hematoma as well as subarachnoid and large left subdural hemorrhages (B; arrow). Three-dimensional reconstruction shows a small hole near the skull entry site (C; arrow), and 3-dimensional oblique reconstruction (D) highlights the trajectory across both cerebral hemispheres. Center. A young patient fatally shot in the right parietal region. There are extensive metal and bone fragments in the right cerebral hemisphere with surrounding hemorrhage (E; arrow), midline shift, and a partially visualized right subdural hematoma (E; arrowhead). Three-dimensional reconstruction shows an extensively comminuted skull fracture with a small residual bullet fragment demarcating the calvarial entry site (F; arrow). Right. A young patient with extensive ballistic injury to the bilateral frontal lobes with bone and metal fragments, hemorrhage, and edema (G; arrow). The force of the gunshot also produced a large and severely comminuted bilateral frontal skull fracture with sinus involvement visible on 3-dimensional reconstruction (H; arrow).
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Antonucci MU. Firearm Injury Prevention. Ann Intern Med. 2019;171:304–305. doi: 10.7326/L19-0210
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Published: Ann Intern Med. 2019;171(4):304-305.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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