Sudden natural death in a suicide attempt

In this article, we report an unusual case of sudden death arising from a ruptured basilar artery aneurysm during a suicide attempt. A 72-year-old male was found dead in his home after sustaining superficial flesh gunshot wounds (entrance and exit) involving the forehead. The victim had been depressed for several months and had frank suicide intention. The pertinent autopsy findings revealed a superficial nonpenetrating bullet path of the scalp with no skull fractures or brain injuries. However, brain examination identified subarachnoid hemorrhage and subdural clot about the brainstem and within the posterior fossa linked to a basilar artery aneurysm rupture. The cause and manner of death and contributing factors of the "non-lethal" gunshot wounds are discussed.