CT brain shows a bullet wound with entry at the RT frontal lode and exit at the LT frontal lobe. The wound cavity is filled with blood. The inset shows a ballistic cavity from a bullet in a gelatin block.
When a bullet strikes a person, tissue is crushed. The bullet's forward movement creates a temporary tunnel that expands to a larger tunnel. The larger tunnel is considered to be a temporary "cavitation" wave. Tissues in the temporary cavity sustain damage from compression, deformation and shear. After a bullet passes through, the temporary cavity recoils , but with a remaining cavity, called the permanent cavity. Tissue of the permanent cavity may be damaged and nonviable. Secondary missiles, such as bullet and bone fragments, can result in additional damage
The wound is created by the physical damage of the bullet itself and cavitation. Cavitation is the formation of vapor bubbles in a flowing liquid in a region where the pressure of the liquid falls below its vapor pressure. Inertial cavitation is the process where a bubble in a liquid rapidly collapses (bursts), producing a shock wave. A shock wave is a wave that carries energy and can propagate through a medium. Shock waves are characterized by an abrupt, nearly discontinuous change in the characteristics of the medium with an extremely rapid rise in pressure, temperature and density.
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