Accused Boston bomber had multiple wounds, fracture: court papers BOSTON (Reuters) - Accused Boston Marathon bomber Dzhokhar Tsarnaev was badly injured when taken into custody by federal agents in April, with multiple gunshot wounds, including one that had fractured his skull, according to unsealed court papers. A trauma surgeon detailed the suspect's condition in a hearing the day the Chechen immigrant, who was lying in a Boston hospital bed, was first charged over the bombing attacks that killed three people and wounded about 264. Tsarnaev, now 20, is the survivor of a pair of brothers accused of carrying out the worst mass-casualty attack on U.S. soil since 9/11. A pair of homemade pressure-cooker bombs exploded on April 15 at the finish line of the Boston Marathon, which was crowded with thousands of spectators, volunteers and athletes. He has multiple gunshot wounds, the most severe of which appears to have entered through the left side inside of his mouth and exited the left face, lower face. This was a high-powered injury that has resulted in skull-base fracture," Dr Stephen Ray Odom of Beth Israel Medical Center testified on April 22, according to court papers unsealed late Monday. Tsarnaev was arrested on April 19, four days after the bombing attack, at the conclusion of a day-long lockdown of most of the Boston area that began when he and his older brother allegedly killed a police officer at the Massachusetts Institute of Technology, carjacked a man and engaged in a gunbattle in the suburb of Watertown that ended with 26-year-old Tamerlan Tsarnaev dead and Dzhokhar on the run. Police found the younger Tsarnaev hiding in a boat in a backyard. Tsarnaev also sustained multiple wounds to his legs and arm but was alert and aware of his surroundings, Odom said. "He definitely knows where he is," Odom said. He knows that he has had multiple procedures, but I'm not sure how aware he is of the specifics. He knows that he has an injury to the neck and to the hand. When Tsarnaev appeared in court in Boston last month to plead not guilty to charges that carry the threat of the death penalty, his face appeared swollen and his left arm was in a cast. Tsarnaev is currently being held at a prison medical center in Fort Devens, Massachusetts, west of Boston, to where he was moved on April 26 after a week at Beth Israel Deaconness Medical Center, a hospital that at the time was also treating many of his alleged victims. The three people who died in the bombing were 29-year-old restaurant manager Krystle Campbell, graduate student Lingzi Lu, 23; and eight-year-old Martin Richard. MIT police officer Collier was killed three days later, according to the indictment. Reporting by Scott Malone; Editing by David Brunnstrom