ABSTRACT
An injury of the scalp is often the sentinel to deeper injuries, like skull fractures, brain contusions, and hematomas. Hair can cover injuries, particularly those that do not bleed, so a careful examination must be undertaken. Small-caliber gunshot wounds are notoriously difficult to find in thick hair. Scalp injuries on the back of the head can be easily overlooked (Figure 5.3). In order to see a scalp wound and photograph it properly, the hair around the wound is carefully shaved (Figure 5.4). The wound in Figure 5.3 is a laceration with an abrasion of the margin. The skull below this area in the same individual revealed a fracture in the back of the head, or occipital bone (Figure 5.5). The opposite part of the brain, or frontal lobe, shows contusions, indicating that the person fell backward and was not struck in the head. Figure 5.6 shows that this is a contrecoup injury.
