The Role of Multi-detector Computed Tomography (MDCT) in Medico-legal Evaluation of Non-Fatal Firearm Head Injuries in Sohag University Hospitals

Document Type : Original Article

Authors

1 forensic medicine and clinical toxicology , Sohag university. sohag governorate

2 Radiology Department, Faculty of Medicine, Sohag University, Sohag, Egypt

3 Neurosurgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt

4 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

Abstract

Background: Multi-detector computed tomography (MDCT) has emerged as a critical noninvasive tool for investigating firearm injuries due to its three-dimensional (3D) imaging capabilities. This study evaluated the role of MDCT with advanced post-processing techniques for medico-legal assessment of non-fatal firearm injuries in the head among patients admitted to Sohag University Hospitals. Methods: This prospective study included 45 male patients aged 11–60 years who sustained non-fatal firearm injuries in the head between September 2023 and September 2024. Forensic examinations were conducted before MDCT imaging. Results: 53.3% of patients sustained non-permanent infirmity injuries, while 46.7% experienced permanent infirmity. Patients <18 years were more likely to have permanent injuries (38.1%), whereas those aged 31–40 years were more likely to have non-permanent injuries (37.5%). Residence played a significant role, with patients from Dar El Salam, Gehina, and Tahta being more associated with permanent infirmities. MDCT findings revealed significant differences in injury patterns. Permanent infirmity was associated with multiple wounds (60%), closer firing distances (<15 meters in 35% of cases), and specific injury sites (right temporal region). Non-permanent injuries were linked to single wounds and firing distances exceeding 15 meters. Retained bullets requiring surgical intervention were found in all cases, and shotgun injuries accounted for 80% of cases without significant differences between injury outcomes. Conclusions: MDCT is crucial in the forensic evaluation of non-fatal firearm injuries to the head, providing exceptional imaging capabilities that aid in accurate medico-legal interpretations.

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