Rotational cerebral injuries near the superior margin of the brain

Abstract

Traumatic lesions near the superior margin of the brain frequently are caused by an anterior or posterior blow to the head. The injuries consist of disruptions of one or a few (with subdural bleeding) or of numerous or all (with instant death or immediate unconsciousness and later death because of simultaneous brain stem injuries) parasagittal bridging veins. Cerebral injuries close beneath the superior margin of the brain occur either alone or together with disruptions of parasagittal bridging veins. These injuries consist mainly of subcortical, perivascular or larger, hemorrhages and of injuries to the white matter. No extensive complete necrosis occurs. The lesions are most frequently found in the posterior part of the superior frontal gyrus and the central gyri and often are combined with brain stem injuries. By reconstruction of trauma events the injuries seem to be caused by a rotational acceleration of the head. By model experiments and simulations it is shown that a rotational acceleration of the skull leads to an "inner deformation" of the brain tissue. This deformation may be the explanation of the subcortical injuries, which are therefore designated rotational cerebral injuries (RC-injuries).