Intracranial ricocheted-bullet injuries: An overview and illustrative case

Unusual Case of Low-Velocity Large Object Penetrating the Frontal Bone with Favorable Outcome: A Case Report in Pediatric Patient

“…Penetrating TBI injuries can be classified into tangential wounds, penetrating wounds, perforating wounds, ricochet, and careening (Figure 5) [12]. Assessing the types of penetrating TBI can help with surgery planning, especially to anticipate complications and stratify prognosis [13]. Judging by its morphology, the penetrating TBI that occurred in our patient was a penetrating wound, although there was no clinical nor radiological brain involvement.…”

Careening intracranial bullets: An existing entity?

“…For example, these injuries may be referred to as ricocheted type B, which, by definition, is a bullet reflecting from the inside table in a trajectory parallel to the cortex. [1] The second objective is to consider whether intracranial bullet wounds with concomitant dural venous sinus injury located outside the direct bullet trajectory should be labeled as careening or as having a careening component, taking into account the theoretical risk of CIBs involving dural venous sinuses, and, most importantly, whether this relabeling will have management and/or prognostic implications.…”

Imaging Ballistic Injuries

“…This is most readily apparent in intracranial GSW, where the curvature of the inner table of the skull predisposes bullets to deflection. 41 It is also important, when a nonlinear trajectory is encountered, to consider and account for the possibility that patient may have been scanned at a different phase of the respiratory cycle or in a different position than he or she was in when shot. 30…”