Cerebral and Cranial Trauma

Anatomy and Pathophysiology of Mild, Moderate, and Severe Head Injury
  • Rhawn Joseph
Part of the Critical Issues in Neuropsychology book series (CINP)

Abstract

The living brain is a soft, delicate tissue with a rather compact gelatinous consistency. Because the brain is so fragile, it is protected by several outercoatings (i.e., membranes) that act as a cushion between it and the hard inner shell of the cranium. The innermost membrane is a sheer sheet of translucent material that actually adheres to the brain surface. This is called the pia mater. Lying above the pia mater is yet another very thin weblike fibrous membrane referred to as the arachnoid. The space between the arachnoid and pia mater is called the subarachnoid space, through which circulates cerebrospinal fluid (CSF). Collectively, the arachnoid and pia mater are called the leptomeninges.

Keywords

Head Injury Severe Head Injury Skull Fracture Retrograde Amnesia Closed Head Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adams, J. H., Graham, D. I., Murray, L. S., Scott, G. (1981). Diffuse axonal injury due to nonmissile head injury in humans: An analysis of 45 cases. Annals of Neurology, 12, 557–563.Google Scholar
  2. Adams, J. H., Graham, D. I., Scott, G. (1980). Brain damage in fatal non-missile head injury. Journal of Clinical Pathology, 33, 1132–1145.PubMedGoogle Scholar
  3. Alberico, A. M., Ward, J. D. Choi, S. C., Marmarou, A., Young, H. F. (1987). Outcome after severe head injury. Journal of Neurosurgery, 67, 648–656.Google Scholar
  4. Alves, W. M., Coloban, A. R. T., O’Leary, T. J., Rimel, R. W., Jane, J. A. (1986). Understanding posttraumatic symptoms after minor head injury. Journal of Head Trauma Rehabilitation, I, 1–12.Google Scholar
  5. Bakay, L., Glasauer, F. E., Alker, G. J. (1980). Head injury. Boston: Little, Brown.Google Scholar
  6. Barth, J. T., Macciocchi, S. N., Giordani, B., Rimel, R., Jane, J. A., Boll, T. J. (1983). Neuropsychological sequelae of minor head injury. Neurosurgery, 13, 529–533.PubMedGoogle Scholar
  7. Bennett, A. E. (1969). Psychiatric and neurologic problems in head injury with medicolegal implications. Diseases of the Nervous System, 30, 314–318.PubMedGoogle Scholar
  8. Berger, M. S., Pitts, L. H., Lovely, M., et al. (1985). Outcome from severe head injury in children and adolescents. Journal of Neurosurgery, 62, 194–199.PubMedGoogle Scholar
  9. Berrol, S. (1986). Evolution and the persistent vegetative state. Head Trauma Rehabilitation, 1, 7–13.Google Scholar
  10. Bromlert, D. M., Sisler, G. C. (1974). The measurement of retrograde post-traumatic amnesia. Canadian Psychiatric Association Journal, 19, 185–192.Google Scholar
  11. Bond, M. R. (1976). Assessment of the psychosocial outcome of severe head injury. Acta Neurochirurgica, 34, 57–70.PubMedGoogle Scholar
  12. Bond, M. R. (1979). The states of recovery from severe head injury with special reference to late outcome. International Rehabilitation Medicine, 1, 155–159.PubMedGoogle Scholar
  13. Brink, J. D., Garrett, A. L., Hale, W. R., Woo Sam, R. A., Nickel, M. G. (1970). Recovery of motor and intellectual function in children sustaining severe head injuries. Developmental Medicine and Child Neurology, 12, 565–571.Google Scholar
  14. Brooks, D. N., Aughton, M. E. (1979). Cognitive recovery during the first year after severe blunt head injury. International Rehabilitation Medicine, 1, 166–172.PubMedGoogle Scholar
  15. Brooks, D. N., McKinlay, W. (1983). Personality and behavioural change after severe blunt head injury-A relative’s view. Journal of Neurology, Neurosurgery and Psychiatry, 46, 336–344.Google Scholar
  16. Bucci, M. N., Phillips, T. W., McGillicuddy, J. E. (1986). Delayed epidural hemorrhage in hypotensive multiple trauma patients. Neurosurgery, 19, 65–68.PubMedGoogle Scholar
  17. Carlsson, C. A., von Essen, C., Lofgren, J. (1968). Factors affecting the clinical course of patients with severe head injuries. Journal of Neurosurgery, 29, 242–251.PubMedGoogle Scholar
  18. Coloban, A. R. T., Dacey, R. G., Alves, W., Rimel, R. W., Jane, J. A. (1986). Neurologic and neurosurgical implications of mild head injury. Journal of Head Trauma Rehabilitation, 1, 13–21.Google Scholar
  19. Cooper, P. R., Maravilla, K., Moody, S., et al.,(1979). Serial computerized tomographic scanning and the prognosis of severe head injury. Neurosurgery, 5, 566–569.Google Scholar
  20. Crockard, A., Iannotti, F., Kang, J. (1982). Posttraumatic edema in the gerbil. In R. G. Grossman P. L. Gildenberg (Eds.), Head injury: Basic clinical aspects. New York: Raven Press.Google Scholar
  21. Dacey, R. G., Alves, W. M., Rimel, R. W., et al. (1986). Neurosurgical complications after apparently minor head injury. Journal of Neurosurgery, 65, 203–210.PubMedGoogle Scholar
  22. Dailey, C. A. (1956). Psychological findings five years after head injury. Journal of Clinical Psychology, 12, 349–353.PubMedGoogle Scholar
  23. Dikmen, S., McLean, A., Temkin, N. (1986). Neuropsychological and.psychosocial consequences of minor head injury. Journal of Neurology, Neurosurgery and Psychiatry, 49, 1227–1232.Google Scholar
  24. Dikmen, S., Reitan, R. M. (1976). Psychological deficits and recovery of functions after head injury. Transactions of the American Neurological Assoication, 101, 72–79.Google Scholar
  25. Dikmen, S., Reitan, R. M., Temkin, N. R. (1983). Neuropsychological recovery in head injury. Archives of Neurology, 40, 333–338.PubMedGoogle Scholar
  26. Dikmen, S., Temkin, N., McLean, A., Wyler, A., Machamer, J. (1987). Memory and head injury severity. Journal of Neurology, Neurosurgery and Psychiatry, 50, 1613–1618.Google Scholar
  27. Dillon, H., Leopold, R. L. (1961). Children and the post-concussion syndrome. Journal of the American Medical Association, 14, 175–186.Google Scholar
  28. Elia, J. C. (1972). The postconcussion syndrome. Industrial Medicine, 41, 23–31.Google Scholar
  29. Fahy, T. J., Irving, M. H., Miller, P. (1967). Severe head injuries. Lancet, 2, 475–478.PubMedGoogle Scholar
  30. Fischer, R. P., Carlson, J., Perry, J. F. (1981). Postconcussive hospital observation of alert patients in a primary trauma center. Journal of Trauma, 21, 920–924.Google Scholar
  31. Fordyce, D. J., Roueche, J. R., Prigatano, G. P. (1983). Enhanced emotional reactions in chronic head trauma patients. Journal of Neurology, Neurosurgery and Psychiatry, 46, 620–624.Google Scholar
  32. Fuld, P. A., Fisher, P. (1977). Recovery of intellectual ability after closed head injury, Developmental Medicine and Child Neurology, 19, 495–502.PubMedGoogle Scholar
  33. Gallagher, J. B., Browder, E. F. (1968). Extradural hematoma. Journal of Neurosurgery, 8, 434–437. Gennarelli, T. A. (1986). Mechanisms of pathophysiology of cerebral concussion. Journal of Head Trauma Rehabilitation, 1, 23–29.Google Scholar
  34. Gennarelli, T. A., Spielman, G. M., Lanfitt, T. W., et al., (1982). Influence of the type of intracranial lesion on outcome from severe head injury. Journal of Neurosurgery, 56, 26–32.PubMedGoogle Scholar
  35. Gennarelli, T. A., Thibault, L. E., Adams, H., et al. (1982). Diffuse axonal injury and traumatic coma in the primate. Annals of Neurology, 12, 564–574.PubMedGoogle Scholar
  36. Gronwall, D. (1976). Performance changes during recovery from closed head injury. Proceedings of the Australian Association of Neurologists, 13, 143–147.PubMedGoogle Scholar
  37. Gronwall, D., Wrightson, P. (1974). Delayed recovery of intellectual function after minor head injury. Lancet, 2, 607–609.Google Scholar
  38. Haas, D. C., Louie, H. (1988). Trauma-triggered migraine: An explanation for common neurological attacks after mild head injury. Journal of Neurosurgery, 68, 181–188.PubMedGoogle Scholar
  39. Haas, J. F., Cope, D. N., Hall, K. (1987). Premorbid prevalence of poor academic performance in severe head injury. Journal of Neurology, Neurosurgery and Psychiatry, 50, 52–56.Google Scholar
  40. Hardman, J. M. (1979). The pathology of traumatic brain injuries. In R. A. Thompson J. R. Green (Eds.), Advances in neurology (Vol. 22 ). New York: Raven Press.Google Scholar
  41. Humphreyes, R. P. (1983). Outcome of severe head injury in children. In A. J. Raimondi (Ed.), Concepts in pediatric neurosurgery (Vol. 3 ). Basel: Karger.Google Scholar
  42. Jane, J. A., Rimel, R. W., Pobereskin, L. H., et al. (1982). Outcome and pathology of head injury. In R. G. Granman P. L. Gildenburg (Eds.), Head injury: Basic and clinical aspects. New York: Raven Press.Google Scholar
  43. Jennett, B. (1975). Scale, scope and philosophy of the clinical problem. In R. Porter D. W. Fitzsimons (Eds.), Outcome of severe damage to the central nervous system. (Ciba). Amsterdam: North-Holland.Google Scholar
  44. Jennett, B. (1978). The problem of mild head injury. Practitioner, 221, 77–82.PubMedGoogle Scholar
  45. Jennett, B., Plum, F. (1972). Persistent vegetative states after brain damage. Lancet, 1, 734–737.PubMedGoogle Scholar
  46. Jennett, B., Miller, J. D., Braakman, R. (1974). Epilepsy after nonmissile depressed skull fracture. Journal of Neurosurgery, 41, 208–216.PubMedGoogle Scholar
  47. Jennett, B., Snoek, J., Bond, M. R., Brooks, N. (1981). Disability after severe head injury. Journal of Neurology, Neurosurgery and Psychiatry, 44, 285–293.Google Scholar
  48. Jennett, B., Teasdale, G. (1977). Aspects of coma after severe head injury. Lancet, 1, 878–881. Jennett, B., Teasdale, G. (1981). Management of head injuries. Philadelphia: F. A. Davis.Google Scholar
  49. Jennett, B., Teasdale, G., Galbraith, S., et al. (1977). Severe head injuries in three countries. Journal of Neurology, Neurosurgery and Psychiatry, 40, 291–298.Google Scholar
  50. Joseph, R. (1982). The neuropsychology of development: Hemispheric laterality, limbic language, and the origin of thought. Journal of Clinical Psychology, 38, 4–33.PubMedGoogle Scholar
  51. Joseph, R. (1988a). Confabulation and delusional denial: Frontal lobe and lateralized influences. Journal of Clinical Psychology, 42, 507–519.Google Scholar
  52. Joseph, R. (1986b). Reversal of cerebral dominance for language and emotion in a corpus callosotomy patient. Journal of Neurology, Neurosurgery and Psychiatry, 49, 628–634.Google Scholar
  53. Joseph, R. (1988). The right cerebral hemisphere: Neuropsychiatry, neuropsychology, neurodynamics. Journal of Clinical Psychology, 44, 630–674.Google Scholar
  54. Klauber, M. R., Marshall, L. F., Toole, B. M., et al. (1985). Cause of decline in head-injury mortality rate in San Diego County, California. Journal of Neurosurgery, 62, 528–531.PubMedGoogle Scholar
  55. Levin, H. S., Benton, A. L., Grossman, R. G. (1982). Neurobehavioral consequences of closed head injury. New York: Oxford University Press.Google Scholar
  56. Levin, H. S., High, W. M., Goethe, K. E., et al. (1987). The neurobehavioral rating scale: Assessment of the behavioural sequelae of head injury by the clinician. Journal of Neurology, Neurosurgery and Psychiatry, 50, 183–193.Google Scholar
  57. Levin, H. S., Mattis, S., Ruff, R. M., et al. (1987). Neurobehavioral outcome following minor head injury. Journal of Neurosurgery, 66, 234–243.PubMedGoogle Scholar
  58. Lezak, M. D. (1987). Relationships between personality disorders, social disturbances and physical disability following traumatic brain injury. Journal of Head Trauma Rehabilitation, 2, 57–69.Google Scholar
  59. Lidvall, H., Linderoth, B., Norlin, B. (1974). Causes of the post concussional syndrome. Acta Neurologica Scandinavica, 56, 1–87.Google Scholar
  60. Lindgren, S. O. (1966). Experimental studies on mechanical effects in head injury. Acta Scandinavica, 132, 187.Google Scholar
  61. Lishman, W. A. (1973). The psychiatric sequelae of head injury. A review. Psychological Medicine, 3, 304322.Google Scholar
  62. Lishman, W. A. (1978). The psychiatric sequela of head injuries. Journal of the Irish Medical Association, 71, 306–314.PubMedGoogle Scholar
  63. Luerssen, T. G., Klauber, M. R., Marshall, L. F. (1988). Outcome from head injury related to patient’s age. Journal of Neurosurgery, 68, 409–416.PubMedGoogle Scholar
  64. Merskey, H., Woodforde, J. M. (1972). Psychiatric sequelae of minor head injury. Brain, 95, 521–528.PubMedGoogle Scholar
  65. Miller, E. (1979). The long term consequence of head injury. British Journal of Social and Clinical Psychology, 18, 87–98.PubMedGoogle Scholar
  66. Miller, H. (1961). Accident neurosis. British Medical Journal, 1, 919–925, 992–998.Google Scholar
  67. Miller, H., Stem, G. (1965). The long term prognosis of severe head injuries. Lancet, 1, 225–227.PubMedGoogle Scholar
  68. Miller, J. D. (1985). Head injury and brain ischaemia—Implication for therapy. British Journal of Anesthesiology, 57, 120–129.Google Scholar
  69. Miller, J. D., Butterworth, J. F., Gudeman, S. K., et al. (1981). Further experience in the management of severe head injury. Journal of Neurosurgery, 54, 289–299.Google Scholar
  70. Morris, J., Roth, E., Davidoff, G. (1986). Mild closed head injury and cognitive deficits in spinal-cord-injured patients. Journal of Head Trauma Rehabilitation, 1, 31–42.Google Scholar
  71. Najenson, T., Groswasser, Z., Mendelson, L., Hackett, P. (1980). Rehabilitation outcome of brain damaged patients after severe head injury. International Rehabilitation Medicine, 2, 17–22.PubMedGoogle Scholar
  72. Najenson, T., Mendelson, L., Schechter, I., et al. (1974). Rehabilitation after severe head injury. Scandinavian Journal of Rehabilitative Medicine, 6, 5–14.Google Scholar
  73. Nikas, D. L. (1987a). Prognostic indicators in patients with severe head injury. Critical Care Nursing Quarterly, 10, 25–34.PubMedGoogle Scholar
  74. Nikas, D. L. (1987b). Critical aspects of head trauma. Critical Care Nursing Quarterly, 10, 19–44.Google Scholar
  75. Noebels, J. L. Prince, D. A. (1978). Development of focal seizures in cerebral cortex: Role of axons terminal bursting. Journal of Neurophysiology, 41, 1267–1281.Google Scholar
  76. Oddy, M., Coughlan, T., Tyerman, A., Jenkins, D. (1985). Social adjustment after closed head injury. Journal of Neurology, Neurosurgery and Psychiatry, 48, 564–568.Google Scholar
  77. Ommaya, A. K., Fass, F., Yamell, P. (1968). Whiplash injury and brain damage: An experimental study. Journal of the American Medical Association, 204, 285–289.PubMedGoogle Scholar
  78. Ommaya, A. K., Grubb, R. L., Naumann, R. A. (1971). Coup and contrecoup injury. Journal of Neurosurgery, 35, 503–516.PubMedGoogle Scholar
  79. Oppenheimer, D. R. (1968). Microscopic brain lesions after trauma. Journal of Neurology, Neurosurgery and Psychiatry, 31, 299–306.Google Scholar
  80. Pedley, T. A. (1978). The pathophysioogy of focal epilepsy: Neurophysiological considerations. Annals of Neurology, 3, 2–9.PubMedGoogle Scholar
  81. Prigatano, G., Fordyce, D. J., Zeiner, H., et al. (1984). Neuropsychological rehabilitation after closed head injury in young adults. Journal of Neurology, Neurosurgery and Psychiatry, 47, 505–513.Google Scholar
  82. Pudenz, R. H., Shelden, C. H. (1946). The lucite calvarium-A method for direct observation of the brain. II. Journal of Neurosurgery, 3, 487–505.PubMedGoogle Scholar
  83. Rabavilas, A. D., Scarpalezos, S. (1981). The post-traumatic syndrome. Some considerations related to psychiatric prevention. Bibliotheca Psychiatrica, 160, 73–77.PubMedGoogle Scholar
  84. Raimondi, A. J., Hirschauer, J. (1984). Head injury in the infant and toddler. Childs Brain, 11, 344–351.Google Scholar
  85. Rimel, R. W., Giordani, B., Barth, J. T., Boll, T. J., Jane, J. A. (1981). Disability caused by minor head injury. Neurosurgery, 9, 221–228.PubMedGoogle Scholar
  86. Rose, J., Valtonen, S., Jennett, B. (1977). Avoidable factors contributing to death after head injury. British Medical Journal, 2, 615–618.PubMedGoogle Scholar
  87. Rosin, A. J. (1977). Reactions of families of brain-injured patients who remain in a vegetative state. Scandinavian Journal of Rehabilitative Medicine, 9, 1–5.Google Scholar
  88. Rowe, M. J., Carlson, C. (1980). Brainstem auditory evoked potentials in post-concussion dizziness. Archives of Neurology, 37, 679–683.PubMedGoogle Scholar
  89. Russell, W. R. (1971). The traumatic amnesiac. London: Oxford University Press.Google Scholar
  90. Schacter, D. L., Crovitz, H. F. (1977). Memory function after closed head injury: A review of the quantitative research. Cortex, 13, 150–176.PubMedGoogle Scholar
  91. Schneider, G. E. (1979). Is it really better to havfe your brain lesion early? A revision of the “Kennard principle.” Neuropsychologia, 17, 557–583.PubMedGoogle Scholar
  92. Sisler, G., Penner, H. (1975). Amnesia following severe head injury. Canadian Psychiatric Association Journal, 20, 333–336.PubMedGoogle Scholar
  93. Smith, E. (1974). Influence of site of impact on cognitive impairment persisting long after severe closed head injury. Journal of Neurology, Neurosurgery and Psychiatry, 37, 719–726.Google Scholar
  94. Snow, R. B., Zimmerman, R. D., Gandy, S. E., (1986). Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury. Journal of Neurosurgery, 18, 45–52.Google Scholar
  95. Squire, L. R., Slater, P. C., Chace, P. M. (1975). Retrograde amnesia. Science, 187, 77–79.Google Scholar
  96. Strich, S. J. (1961). Shearing of nerve fibers as a cause of brain damage due to head injury. Lancet, 2, 443–448.Google Scholar
  97. Symonds, C. (1962). Concussion and its sequelae. Lancet, 1, 1–5.Google Scholar
  98. Staller, A. G. (1987). Systemic effects of severe head trauma. Critical Care Nursing Quarterly, 10, 58–68.Google Scholar
  99. Taylor, A. R., Bell, T. K. (1966). Slowing of cerebral circulation after concussional head injury. Lancet, 2, 178–180.PubMedGoogle Scholar
  100. Teasdale, G., Mendelow, D. (1984). Pathophysiology of head injuries. In N. Brooks (Ed.), Closed head injury. New York: Oxford University Press.Google Scholar
  101. Teasdale, G., Skene, A., Spiegelhater, D., Murry, L. (1982). Age, severity, and outcome of head injury. In R. G. Grossman P. L. Gidenberg (Eds.), Head injury: Basic and clinical aspects. New York: Raven Press.Google Scholar
  102. Thomsen, I. (1974). The patient with severe head injury and his family. Scandinavian Journal of Rehabilitative Medicine, 6, 180–183.Google Scholar
  103. Tobias, J. S., Puria, K. B., Sheridan, J. (1982). Rehabilitation of the severely brain-injured. Scandinavian Journal of Rehabilitative Medicine, 14, 83–88.Google Scholar
  104. Toglia, J. U., Rosenberg, P. E., Ronis, M. L. (1970). Post traumatic dizziness. Archives of Otolaryngology, 92, 7–13.Google Scholar
  105. Toole, J. F. (1984). Cerebrovascular disease. New York: Raven Press.Google Scholar
  106. Tubbs, O. N., Potter, J. M. (1970). Early post concussion headache. Lancet, 2, 128–129.PubMedGoogle Scholar
  107. Unterharnscheidt, F., Sellier, K. (1966). Mechanisms and pathomorphology of closed head injury. In W. F. Caveness A. E. Walker (Eds.), Head injury. Philadelphia: J. B. Lippincott.Google Scholar
  108. Waddell, P. A., Gronwall, D. M. A. (1984). Sensitivity to light and sound following minor head injury. Acta Neurologica Scandinavica, 69, 270–278.PubMedGoogle Scholar
  109. Weddell, R., Oddy, M., Jenkins, D. (1980). Social adjustment after rehabilitation. Psychological Medicine, 10, 257–263.PubMedGoogle Scholar
  110. Wowem, Von F. (1966). Post traumatic amnesia and confusion as an index of severity in head injury. Acta Neurologica Scandinavica, 42, 373–378.Google Scholar
  111. Yarnell, P. R., Lynch, S. (1970). Retrograde memory immediately after concussion. Lancet, 1, 863–864.PubMedGoogle Scholar
  112. Zimmerman, R. A., Bilianiuk, L. T., Gennarelli, T. A. (1978). Computerized tomography of shearing injuries of the cerebral white matter. Radiology, 127, 393–396.Google Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Rhawn Joseph
    • 1
  1. 1.Neurobehavioral CenterSanta ClaraUSA

Personalised recommendations