Schussbedingtes Schädel-Hirn-Trauma

Gunshot injuries to the head usually present special findings due to the anatomical conditions of the head (brain enclosed in a relatively solid skull capsule). From a physical wound ballistic view the brain is a very inelastic and incompressable object/tissue. In general this is the reason why gunshots to the head lead to lethal fluid dynamic effects even when no vitally important structures have been directly injured. Severe brain injuries can occur even distant from the wound canal mainly due to distensional and shearing for-ces during the development of the temporary wound cavity. The lower the cross-sectional density and the more energy a bullet has, the more these effects will be pronounced. Even gunshots with caliber 9 mm Luger can result in hydraulic pressure effects with development of complex fracturing of the skull.