Traumatismo cranioencefálico por projétil de arma de fogo com enfoque no diagnóstico traumatológico na análise do trajeto e nos efeitos sobre a decomposição cadavérica em clima tropical

Abstract

Introduction: Craniocerebral firearm injuries require correlation among soft-tissue lesions, osseous defects, fractures, and intracranial changes. In decomposed bodies, this interpretation may be limited by tissue loss, entomological activity, and taphonomic modifications. Objective: To synthesize the criteria for characterizing entrance and exit wounds, trajectory analysis, and sequencing of cranial fractures, and to critically assess the hypothesis that open cranial trauma modifies decomposition and postmortem interval estimation in tropical climates. Methods: An integrative review guided by the Population or Problem, Concept, and Context framework. Studies published between January 2021 and May 2026 were prioritized and complemented by classic references and earlier experimental studies essential to the traumatological and taphonomic discussion. Results: Internal beveling at the entrance and external beveling at the exit are common patterns, but exceptions occur, particularly in tangential impacts and anatomically complex bones. Puppe’s rule may assist in sequencing impacts, but it should not be applied in isolation. Postmortem computed tomography provides additional information on projectiles, fragments, and fractures without automatically replacing autopsy. Regarding decomposition, loss of cranial integrity may modify the regional pattern and facilitate brain exposure, but experimental studies do not demonstrate uniform acceleration of whole-body decomposition or an invariable entomological preference for wounds. Conclusion: Interpretation should integrate external and internal examinations, postmortem imaging, osseous reconstruction, environmental context, and entomology. The influence of trauma on decomposition should be presented as a contextual and regional hypothesis, with explicit acknowledgment of uncertainty and without universal correction factors for the postmortem interval.