1. BRAIN INJURIES
The brain may be injured:
• By direct intrusion, either by a foreign object
such as a penetrating weapon, bullet
)
• By deformation of the brain in closed head
injuries )
(direct&indirect)
2. Mechanism of indirect brain damage
• The mechanism is mainly:
1- acceleration deceleration
2- rotational movement shearing strain)
11. A-Brain concussion
It is a state of sudden transient loss
of consciousness following head
injuries. It is characterised by
momentary physiological disruption of
the function of the brain with little or
no noticeable anatomical
* Fate of concussion
changes.(shaking of the brain)
1- Complete uncomplicated
recovery
2- compression
3- death
12. B- brain contusion
C- brain laceration
Both contusion and laceration can occur in
cases of coup or contre-coup lesion.
Occure in the outer layers .in the frontal &temporal lobes
13. D- cerebral edema
- Increased brain size&weight
- flattining of gyri&disappearance of sulci
- pallor of the brain
-Signs of herniation &shifting
- difficulty in the differentiation between
grey&white matter
- slicing the brain show wet cut surface&fluid
oozing
15. Practical notes
There may be no coup damage at all, only
contrecoup.
May be no fracture of skull, even in the
presence of severe coup and contrecoup
lesions.
The most common site for contrecoup injury is
in the frontal lobes .It is often at the tips of the
frontal poles and may be symmetrical, if a fall
on the occiput has occurred.
16. Notes…..cont.
In a temporal impact, the contrecoup damage
may be not be on the contralateral
hemisphere, but on the opposite side of the
ipsilateral hemisphere from impact against the
falx cerebri.
The degree of contrecoup damage may be
severe,more than coup , especially in the frontal
lobes and tips of the temporal lobes.
17. Sequelae of Head Injuries:
1- Retrograde amnesia:
Loss of memory concerning the accident itself and for
sometimes before the accident (partial amnesia).
2- Post-traumatic automatism:
The patient may do voluntary acts after the accident or
even commits a crime. But he forgets every thing about what
he did.
3- Post traumatic neurosis:
The patient may complain of some vague symptoms as
headache, anxiety and insomnia. Sometimes all of these
symptoms disappear after the victim receives the financial
compensation.
4- Pos traumatic epilepsy:
Due to adhesion between the site of the trauma and the
meninges.
5- Sepsis: meningitis, brain abscess and sinus thrombosis.
18. Causes of death in head injuries:
1. Rapid death: concussion, compression and
brain laceration
2. Delayed death:
Infections: e.g. meningitis, brain abscess and
sinus thrombosis.
Indirectly from epilepsy
