HEADINJURIES.pptVIP

HEAD INJURIES Forensic Pathology RAISED INTRACRANIAL PRESSURE Compensatory Mechanisms: ----Displacement of blood ----Displacement of CSF ----Loss of Brain Tissue RAISED INTRACRANIAL PRESSURE EFFECTS: -Compression of Brain -Stretching of IIIrd nerve -Stretching of Posterior Cerebral Artery HERNIATION---Subfalcine (supracallosal) ---Tentorial ---Cerebellar Tonsillar Coning RAISED INTRACRANIAL PRESSURE SIGNS SYMPTOMS: -----Headache -----Vomiting -----Papilloedma DANGER OF LUMBAR PUNCTURE! IMPACT INJURIES Scalp (abrasions,bruises,lacerations) Skull Fractures Cerebral Contusions Extradural Haemorrhage Intracranial Haemorrhage ACCELERATION/ DECELERATION INJURIES Subdural Haemorrhage Diffuse Axonal Injury (DAI) Scalp Injuries Abrasions Contusions Lacerations(with or without avulsion) Risk of: Haemorrhage Infection SKULL FRACTURES Does NOT always correlate with Brain Injury May have skull # without significant Brain Injury May have severe Brain Injury without a skull # SKULL FRACTURES May involve Calvaria or Base Mechanism of Skull Fractures due to Blunt Force Trauma “Deformed Hoop” --outbending of skull away from impact site—fracture begins here and runs back to impact site SKULL FRACTURES HIGH VELOCITY IMPACT ---produces Penetrating or Depressed Fractures FLAT IMPACTS ---produce Linear,Non-Displaced Fractures SKULL FRACTURES Skull impacting hard,unyielding surface---33-75 ft.lb energy needed to produce a linear fracture (6ft man 29-45 mph) Skull impacting soft,yielding surface----268-581 ft.lb energy needed to produce a linear skull fracture(6ft man 13.5 mph) Probability of Skull Fracture with BFT Depends on Severity of Blow (speed of impact) Object Impacted or Impacting Head (weight,shape,consistency) Thickness of Hair Thickness of Scalp Thickness of Skull Age of Victim (elasticity,brittleness of bone) Types of Skull Fracture Linear # -straight or curved lines -tend t