In a contact gunshot wound to the skull, the wound of entrance typically shows a 'cruciate laceration' or star-shaped appearance. This is caused by:

• A The hollow-point bullet expanding at the moment of skin contact
• B Muzzle gases entering the wound track, expanding under skin over bone, and bursting back outward ✓
• C Radial stress fractures from the bullet's kinetic energy transfer to the skull
• D Thermal burns from the hot barrel singeing skin in a radial pattern

Explanation

In a firm contact or hard-contact wound over bone, the bullet penetrates and is immediately followed by muzzle gases under high pressure. These gases, trapped between the skin and the underlying skull, expand laterally under the skin and then blow back outward — splitting the skin in 3 or 4 stellate (star-shaped) directions. The resulting wound is larger than the bullet calibre and has cruciate or stellate lacerations with blackened, burned, and gas-distended edges. This is pathognomonic of hard-contact firing over a bony surface.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.