Date of Award

6-2025

Degree Type

Thesis

Degree Name

Master of Science in Biomedical Sciences

First Advisor

Richard Gonzalez PhD

Second Advisor

Kerin Claeson PhD

Third Advisor

Allison Machnicki PhD

Abstract

Gunshot injuries to the head present a complex challenge in both clinical and forensic contexts. This study uses the Maxillofacial Injury Severity Score (MFISS) – a system used by surgeons to assess traumatic head injuries on a 0 – 4 scale– to evaluate postmortem imaging. By applying the MFISS to postmortem cases, this research aims to reverse engineer trauma manifestation to explain initial ballistic injury in head gunshot (GSWH) victims to be translated into current clinical practice, particularly reconstructive surgery and preventative care. This study hypothesizes that applying the MFISS to postmortem head gunshot imaging will provide valuable data for preventative treatment strategies and enhance the accuracy of injury assessment utilizing Computed Tomography (CT). The research uses a sample of 36 postmortem CT scans from the New Mexico Decedent Image Database (nmdid.unm.edu). Three-dimensional hard and soft tissue reconstructions were created for each case utilizing the medical imaging software Horos (Horosproject.org). The CT images along with 3D reconstructions were utilized to track the projectile pathway and establish the total MFISS score. Two regression analyses utilizing IBM SPSS Statistics (IBM SPSS Statistics 30) assessed the reliability of the MFISS in predicting the likelihood of survivability of GSWH victims. Significance (p < 0.05) was found for the total score, Zone 1 and Soft Tissue scores. These findings support MFISS as a reliable tool for injury assessment. This study aims to bridge the gap between forensic data and clinical practice through reverse engineering trauma manifestation to enhance surgical planning and preventative strategies in maxillofacial trauma care.

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