Human Studies of Head Injury

Abstract

Neuropathological studies of brains from consecutive patients dying as a result of blunt head injury have shown obvious signs of ischaemic damages in 91%. These changes are found in the cerebral cortex in 46%, hippocampus 81%, cerebellum 36% and to the basal ganglia in 79% (Graham et al. 1978). Moreover, direct impact after a blunt lesion and secondary events like hypotension might result in localized necrosis at boundary zones between the major cerebral arteries (water shed lesions) (Adams et al. 1966, Adams and Graham 1976); furthermore, neuropathological findings of brain herniation suggest well-defined ischaemic lesions of parahippocampal and cingulate gyri, and infarction in the medial occipital cortex (Adams and Graham 1976). The ischaemic brain damage is probably due to intracranial hypertension caused by mass lesions and brain swelling (Langfitt and Gennarelli 1982).