Copper jacketed bullets in the central nervous system

Bullets fired from hand guns are often partially or fully jacketed with copper - a fact that can usually be recognized on radiographs. The copper content of the metallic foreign body (MFB) appears to be more toxic than unjacketed lead and sometimes leads to migration of the MFB through brain tissue. Therefore, it appears wise to attempt to recognize and remove copper containing MFBs when they lie in contact with the central nervous system. Plain lead missiles and those partially clad with copper often leave traces of lead along their paths, while those that are completely copper clad do not. Partially clad missiles tend to show some separation of lead and copper - revealing two differing metallic densities on the radiographs.