Suicide with two shots to the head inflicted by a captive-bolt gun

An exceptional case of suicide with two shots to the head inflicted by a captive-bolt gun is reported here. The pathophysiology observed, and related literature, indicate that the capacity of the victim to fire a second shot depended on the depth of skull penetration by the first shot and the extent of damage to nerve structures. In this case, an ante mortem multi-detector computed tomography was possible. From discussion with the radiologist and a 3D reconstruction, the two-shot suicide scenario could be confirmed.