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In some contact rifle wounds of the head, the entrance may be difficult to locate because of the massive destruction. In the case of a high-powered firearm, the amount of force generated by the blast is so large that a shot fired with the weapon in contact with the head causes extensive destruction. Head injuries from shotguns and high-powered rifles are typically quite devastating, often with extensive soft tissue destruction, skull fractures, and pulpifaction of the brain. Occasionally, the brain is largely expelled from the cranial vault and may be found near the body.

Fig1. Contact rifle wound of the head.

The head is the most common location for a suicidal gunshot wound (74%), followed by the chest (20%) and then the abdomen (6%). In head wounds, the most common location was intraoral (50%), followed by under the chin (19%); side of head, including parietal and temporal wounds (15%); and the face, including the forehead (13%).

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