Severe epistaxis from an intracranial vascular bleed from grenade injury.

This case demonstrates the importance of trajectory analysis of blast and/or ballistic penetrating head and neck injuries. In particular, this case focuses on an intracranial vascular injury generated by a hand grenade with the diagnosis assisted by trajectory mapping using MDCT (Multi-Detector CT) volumetrically acquired datasets. Further, this case shows the usefulness of reformatted images to analyze projectile wound trajectories and reviews complex anatomic planes for use in triage, treatment, and incident analysis in penetrating trauma.