Introduction:

Brain Trauma. Most traumatic brain injuries are the result of motor vehicle accidents. During the accident, the head strikes something firm and resistant or the head rocks quickly backward and forward. Both events may occur together and this results in significant injury of the brain. As the brain moves forward and backward, white matter pathways are strained and tear. Certain parts of the brain also strike resistant parts of the skull and brain structures, such as the falx and anterior parts of the skull. The rotational injury produces mechanical trauma of the white matter and blood vessels within the white matter. Damaged blood vessels hemorrhage and this compresses the surrounding brain tissue. When the brain strikes the interior surface of the skull, this may also produce contusion and hemorrhage.

Causes.There are two main sources of lesion in traumatic brain injury: direct mechanical trauma and secondary complications. Mechanical trauma includes diffuse axonal injury and contusions. Complications include increased intracranial pressure (ICP), hematoma, anoxia, infections, and hemodynamic instability.