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Brain Trauma Dr. Raid Jastania, FRCPC

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Presentation on theme: "Brain Trauma Dr. Raid Jastania, FRCPC"— Presentation transcript:

1 Brain Trauma Dr. Raid Jastania, FRCPC
Assistant Professor, Faculty of Medicine, Umm Alqura University Vice Dean, Faculty of Dentistry

2 Reference and Contact Robbins Basic Pathology

3 Brain Trauma Important Factors: Site of injury Severity
Energy: velocity, mass Blunt force Sharp force Static head, moving head, rotational force Associated injury

4 Intracranial Hemorrhage
Types: Epidural (Extra dural) Subdural Subarachnoid Space occupying lesion Increased intracranial pressue Decreased blood flow Brain ischemia Herniation

5 Epidural Hemorrhage Fracture of skull plates
Meningeal arteries run in grooves in the inner side of bone plates Common injury of middle meningeal arteries at the temporal bone Bleeding in extradural space Displacement of brain Rarely due to venous injury


7 Subdural Hemorrhage Rotational or shearing force
Injury of venous sinuses Common in the very young and the very old May be present without skull fracture May organize


9 Subarachnoid Hemorrhage
Very common Usually small and not fatal Associated with brain contusion and laceration May be fatal if large Most common non-traumatic is due to rupture berry aneurysm in the circle of Willis


11 Brain Injury Contusions and lacerations Fracture Penetrating injury
Hemorrhage Rotational injury Acceleration/Deceleration injury Shearing between different layers of brain Laceration deep in the brain Common at region of corpus callosum Diffuse axonal injury

12 Brain Injury Sometimes in the absence of hemorrhage
Results in cerebral edema Swelling of brain Increased intracranial pressure Herniation: tentorium cerebelli and foramen magnum Findings: heavy brain, flat surface, hemorrhage and necrosis, compression of ventricles

13 Parenchymal Injury Changes: Wedge shape injury Edema Hemorrhage
Subarachnoid hemorrhage Neuronal injury Inflammation Gliosis Cavity Diffuse axonal injury

14 Brain Injury Coup and contrecoup injury:
Coup injury occurs when a static head is stuck Injury of scalp will overly injury to brain Contrecoup injury: Skull and brain are moving and suddenly arrested Injury of brain is opposite to scalp or skull injury

15 Herniation Subfalcine herniation Transtentorial herniation
Tonsillar herniation


17 Subfalcine herniation
Unilateral expansion of brain Displaces cingulate gyrus Compress anterior cerebral artery


19 Transtentorial herniation
Medial aspect of the temporal lobe Compression of 3rd cranial nerve, pupillary dilatation Posterior cerebral artery, occipital lobe infarct Compression of contralateral cerebral peduncle, ipsilateral hemiparesis Duret hemorrhage in pons and midbrain


21 Tonsillar herniation Cerebellar tonsils through foramen magnum
Compression of respiratory centers in the medulla


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