What are mechanisms that cause primary traumatic brain injury (TBI)?

Updated: Mar 02, 2020
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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The 2 main mechanisms that cause primary injury are contact (eg, an object striking the head or the brain striking the inside of the skull) and acceleration-deceleration. Primary injury due to contact may result in injury to the scalp, fracture to the skull, and surface contusions. Primary injury due to acceleration-deceleration results from unrestricted movement of the head and leads to shear, tensile, and compressive strains. These forces can cause intracranial hematoma, diffuse vascular injury, and injury to cranial nerves and the pituitary stalk. [2]

Contusions are distinct areas of swollen brain tissue. [19] They are typically found on the poles of the frontal lobes, the inferior aspects of the frontal lobes, the cortex above and below the operculum of the sylvian fissures, and the lateral and inferior aspects of the temporal lobes.

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