A Suicide Attempt with a Velo-Dog Pocket Revolver in an Alleged Victim of Carjacking

: In hospital emergencies, we can have the most picturesque and impressive cases, from the simplest to the most complex. Violence cases are not rare, and among these are the injuries caused by ﬁrearms, which may vary in severity depending on the affected region and the energy of the projectile. Head injuries are generally very serious, and it is rare the individuals survival without sequelae. This work reports a 38-year-old man who was admitted to the emergency room alone in the morning, walking, lucid, and oriented, mentioning that the night before he was in the car and that he had been shot in the head in an attempt at carjacking. On examination, he had only one entry wound in the right temporal region, and the history revealed a suicide attempt with a very rare ﬁrearm: a Velo-Dog. We hypothesized that the low-density energy of this revolver, which historically used to be carried by cyclists as a defense against dog attacks, may partially explains the non-skull penetration.


Introduction
While riding a bicycle, especially in the era before regulation was applied to pets and working animals, many cyclists were chased by dogs.This phenomenon led to the invention and popularity of a unique series of revolvers (i.e., the Velo-Dog), one of the smallest revolvers ever placed into production.The Velo-Dog (also known as a "Revolver de Poche") was a pocket revolver originally created in France by René Galand, son of Charles-François Galand, in 1894 to be carried cyclists as a defense against dog attacks [1,2].The name is composed of "velocipede" and "dog".The available revolvers vary considerably in appearance, but all have certain common features: short barrels, small calibers (e.g., 0.22 or 0.25), a shrouded hammer, and lack of a trigger guard [1,2].The original revolver used a 5.75-mm (i.e., 0.22-caliber) Velo-Dog cartridge, which is still made by Fiocchi ® (Lecco, Italy).
This work reports on a very unusual case of a 38-year-old man who is admitted to the emergency room, mentioning that the night before he was in the car and that he had been shot in the head in an attempt at carjacking.The history revealed a suicide attempt with an antique Velo-Dog firearm.

Case Report
A 38-year-old man entered an emergency room on his own feet, lucid and oriented, saying that the night before he was in the car and that he had been shot in the head in an attempted carjacking 4 h before.On examination, he presented only one entry wound in the right temporal region (Figure 1).The observation of the entrance orifice revealed a regular, oval-shaped wound with inverted edges, an excoriated and echimotic area with gunpowder tattooing (i.e., a dirty ring), and a circular black zone of soot typical of shots with a barrel slightly in contact to allow some escape of GSR elements around the hole, but without any tattoo zone.
attempted carjacking 4 h before.On examination, he presented only one entry wound in the right temporal region (Figure 1).The observation of the entrance orifice revealed a regular, oval-shaped wound with inverted edges, an excoriated and echimotic area with gunpowder tattooing (i.e., a dirty ring), and a circular black zone of soot typical of shots with a barrel slightly in contact to allow some escape of GSR elements around the hole, but without any tattoo zone.The X-ray (Figure 2a,b) and computerized tomography scan (Figure 2c,d) evidenced a projectile lodged between the scalp and the skull, suggesting a low-density projectile energy to penetrate the skull.Based on these findings, it was clear that the story reported by the victim could not be true, since a shot fired from outside the car (within the range of 1 m) with the open window in his story would not produce the black soot.The X-ray (Figure 2a,b) and computerized tomography scan (Figure 2c,d) evidenced a projectile lodged between the scalp and the skull, suggesting a low-density projectile energy to penetrate the skull.Based on these findings, it was clear that the story reported by the victim could not be true, since a shot fired from outside the car (within the range of 1 m) with the open window in his story would not produce the black soot.
attempted carjacking 4 h before.On examination, he presented only one entry wound in the right temporal region (Figure 1).The observation of the entrance orifice revealed a regular, oval-shaped wound with inverted edges, an excoriated and echimotic area with gunpowder tattooing (i.e., a dirty ring), and a circular black zone of soot typical of shots with a barrel slightly in contact to allow some escape of GSR elements around the hole, but without any tattoo zone.The X-ray (Figure 2a,b) and computerized tomography scan (Figure 2c,d) evidenced a projectile lodged between the scalp and the skull, suggesting a low-density projectile energy to penetrate the skull.Based on these findings, it was clear that the story reported by the victim could not be true, since a shot fired from outside the car (within the range of 1 m) with the open window in his story would not produce the black soot.The support of the judicial police was then requested to clarify the case, and a 6.35 × 16 SR mm Velo-Dog revolver was found at the victim's home (Figure 3).The Velo-Dog revolver was inherited from a relative, and it is now obsolete.Once faced with these findings, the victim ended up confessing that he fabricated the story of aggression, admitting that he suffered from depression that motivated him to attempt suicide at home.Previous clinical records were not available.The patient fully recovered without major sequels.
The support of the judicial police was then requested to clarify the case, and a 6.35 × 16 SR mm Velo-Dog revolver was found at the victim's home (Figure 3).The Velo-Dog revolver was inherited from a relative, and it is now obsolete.Once faced with these findings, the victim ended up confessing that he fabricated the story of aggression, admitting that he suffered from depression that motivated him to attempt suicide at home.Previous clinical records were not available.The patient fully recovered without major sequels.

Discussion
Gunshot wounds to the head are reported means of suicide encountered in the forensic autopsy practice, especially in men, while women more likely to choose overdosing [3][4][5][6][7].In particular, Velo-Dog revolvers possess a very low-density energy compared with typical handguns, and as evidenced in our case, even close-contact injuries will probably be non-fatal.An essential task of the forensic expert is the reconstruction of events leading to injuries or death, since they can provide valuable information regarding the manner or the cause of production, such as self-inflicted versus inflicted by someone else and as a result of a suicide attempt, accident, or homicide [8].Close-range or contact injuries from handguns are more often encountered in civilian life, especially in western Europe, and they are thus of particular interest to forensic experts.In the present case, the size, shape of the injury, and abrasions on the right temporoparietal region were interpreted as an entrance wound inflicted by the Velo-Dog.Moreover, the soot depositions around the wound margins were also suggestive of close-range gunshot wounds.Compared with a previous reported case, this was a non-fatal single shot [9].In that case, the authors observed that the first shot only injured the surface of the outer table of the skull without penetrating the cranial cavity and therefore did not damage the brain or cause any loss of consciousness.In our case, a justification for the failure to penetrate the skull could be explained by the relatively low-density energy of the projectiles used with Velo-Dog revolvers and perhaps due to the application of a single shot.Nevertheless, penetration of the temporal bone at a short distance usually requires lower-density energy (J/mm 2 ; calculated by dividing the kinetic energy of the projectile by the projectile's cross-sectional area) compared with what is expected for this firearm [10,11].Therefore, further reasons could be highlighted.When the firearm was examined, the interior of the barrel was heavily contaminated with soot, suggesting that ammunition combustion had been defective, further reducing the energy of the projectile.An important limitation needs to be mentioned, namely, further information regarding the ammunition and firearm used would be interesting to understand the wounding dynamics, but unfortunately, such data were not available.

Discussion
Gunshot wounds to the head are reported means of suicide encountered in the forensic autopsy practice, especially in men, while women more likely to choose overdosing [3][4][5][6][7].In particular, Velo-Dog revolvers possess a very low-density energy compared with typical handguns, and as evidenced in our case, even close-contact injuries will probably be nonfatal.An essential task of the forensic expert is the reconstruction of events leading to injuries or death, since they can provide valuable information regarding the manner or the cause of production, such as self-inflicted versus inflicted by someone else and as a result of a suicide attempt, accident, or homicide [8].Close-range or contact injuries from handguns are more often encountered in civilian life, especially in western Europe, and they are thus of particular interest to forensic experts.In the present case, the size, shape of the injury, and abrasions on the right temporoparietal region were interpreted as an entrance wound inflicted by the Velo-Dog.Moreover, the soot depositions around the wound margins were also suggestive of close-range gunshot wounds.Compared with a previous reported case, this was a non-fatal single shot [9].In that case, the authors observed that the first shot only injured the surface of the outer table of the skull without penetrating the cranial cavity and therefore did not damage the brain or cause any loss of consciousness.In our case, a justification for the failure to penetrate the skull could be explained by the relatively low-density energy of the projectiles used with Velo-Dog revolvers and perhaps due to the application of a single shot.Nevertheless, penetration of the temporal bone at a short distance usually requires lower-density energy (J/mm 2 ; calculated by dividing the kinetic energy of the projectile by the projectile's cross-sectional area) compared with what is expected for this firearm [10,11].Therefore, further reasons could be highlighted.When the firearm was examined, the interior of the barrel was heavily contaminated with soot, suggesting that ammunition combustion had been defective, further reducing the energy of the projectile.An important limitation needs to be mentioned, namely, further information regarding the ammunition and firearm used would be interesting to understand the wounding dynamics, but unfortunately, such data were not available.
This case report illustrates a very unusual suicide attempt with a Velo-Dog pocket revolver and highlights the importance of terminal ballistics in the forensic medical approach.

Figure 1 .
Figure 1.External examination of the victim at the emergency room approximately 4 h after shot revealed an entrance hole of the projectile in the skull in the right temporal bone with excoriation and wound edge (1), burning zone (2), and soot zone with gunpowder residue deposited around the wounds (3).

Figure 2 .
Figure 2. Face (a) and anteroposterior X-ray (b) and respective computerized tomography scans (c,d) of the skull, demonstrating the extracranial location and the deformed lead projectile at the right temporal region.

Figure 1 .
Figure 1.External examination of the victim at the emergency room approximately 4 h after shot revealed an entrance hole of the projectile in the skull in the right temporal bone with excoriation and wound edge (1), burning zone (2), and soot zone with gunpowder residue deposited around the wounds (3).

Figure 1 .
Figure 1.External examination of the victim at the emergency room approximately 4 h after shot revealed an entrance hole of the projectile in the skull in the right temporal bone with excoriation and wound edge (1), burning zone (2), and soot zone with gunpowder residue deposited around the wounds (3).

Figure 2 .
Figure 2. Face (a) and anteroposterior X-ray (b) and respective computerized tomography scans (c,d) of the skull, demonstrating the extracranial location and the deformed lead projectile at the right temporal region.

Figure 2 .
Figure 2. Face (a) and anteroposterior X-ray (b) and respective computerized tomography scans (c,d) of the skull, demonstrating the extracranial location and the deformed lead projectile at the right temporal region.

Figure 3 .
Figure 3.A 6.35 × 16 SR mm caliber Velo-Dog revolver found at victim's home with clear correspondence with the gun barrel.

3 .
A 6.35 × 16 SR mm caliber Velo-Dog revolver found at victim's home with clear correspondence with the gun barrel.