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MSU College of Osteopathic Medicine

I. General Principles

B. Mechanisms of damage in closed-head injury (cont)

2. Rotation of brain within cranial cavity

  • shearing of bridging veins producing subdural hemorrhage
  • shearing of small vessels producing petechial intracranial hemorrhages or subarachnoid hemorrhage
  • shearing stresses in brain causing rupture or stretching of axons
  • contusions: the orbital surfaces may be damaged by contact with the floor of the anterior fossa; the temporal lobe tips may be damaged by edges of the sphenoid ridge;   the corpus callosum may be damaged by the falx cerebri; the superior surface of the cerebellum or brainstem may be injured by contact with the tentorium cerebelli.

3. Secondary damage may be produced by the space-occupying effects of edema and/or hematoma

C. Additional mechanisms of damage involved in open-head injuries.

  • Direct inoculation of bacteria
  • Laceration by bony fragments