External beveling of cranial gunshot entrance wounds

Entrance gunshot wounds of the skull generally have internal beveling. External beveling has been previously described in association with internal beveling (keyhole defect) and with wounds from handgun projectiles. An accidental shooting is described in which a 22-year-old male sustained a perforating gunshot wound of the head at distant range from a 5.56-mm (.223-caliber) fully jacketed rifle round. Although the entrance wound had symmetrical external beveling, misinterpretation of this particular entrance wound as an exit wound would have been difficult.