Original ArticlesMedicolegal Investigations in Cases of Double Suicidal Gunshots to the Head Using 2 Different Handguns A Report of an Unusual CaseMoreschi, Carlo MD∗; Da Broi, Ugo MD, PhD∗; Ciccone, Leonardo MD∗; Stocca, Tiziano MD†Author Information From the ∗Department of Medical Area, Section of Forensic Medicine, University of Udine, Udine †Department of Radiology, Gorizia General Hospital, Gorizia, Italy. Manuscript received October 31, 2018; accepted March 11, 2019. The authors report no conflict of interest. The authors report no funding received. Reprints: Ugo Da Broi, MD, PhD, Sezione Dipartimentale di Medicina Legale–Dipartimento di Area Medica, Università degli Studi di Udine, Piazzale Santa Maria della Misericordia, 15-33100 Udine, Italy. E-mail: [email protected]. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.amjforensicmedicine.com). The American Journal of Forensic Medicine and Pathology: September 2019 - Volume 40 - Issue 3 - p 266-268 doi: 10.1097/PAF.0000000000000487 Buy SDC Metrics Abstract Suicides committed by firing 2 gunshots to the head are rare events and pose a significant challenge for coroners and forensic pathologists. The evaluation of the victim's ability to fire 2 shots simultaneously, or to act after a first gunshot, is crucial for the reconstruction of the death scene and to differentiate between homicide and suicide. We report an unusual case of suicide involving 2 gunshot wounds to the head. The medicolegal investigations hypothesized that the victim had either fired 2 shots near simultaneously or he suffered from rapid incapacitation after the first gunshot but was still able to fire a second consecutive and fatal shot to the head. This article focuses on the diagnostic difficulties involved, together with analysis of the death scene and autopsy findings, in cases where the courts demand confirmation that a double gunshot to the head is in fact a case of suicide. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.