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Regional injuri

A. Skull fracture:
  1. Linear or Fissured – most common type
  2. Depressed – also k/a SIGNATURE FRACTURE - blow of heavy weapon having small striking area. E.g. stones, stick, axe, hammer. Outer table driven into the diploe, inner table fractured
  3. Pond or Indented – in elastic skulls as in infants.
  4. Gutter – when glance bullet strikes (tangentially), a part of thickness of bone is removed, forming a gutter. 
  5. Communited – multiple fracture of skull, also k/a SPIDER WEB FRACTURE *
  6. Diastic or SuturalQ fractures: Separation of the sutures occur only in young persons.
  7. Motorcyclist fracture  – Due to secondary impact with the ground a fracture is produced across the floor of each middle fossa passing through the pituitary fossa, seen in the classical fatal injury in both motorcyclist & pillion passenger. At autopsy the base of skull is seen divided into two halves, each moving independent of each other like a hinge.res
  8. Diastic or sutured fracture – Separation of sutures occurs in young person when sutures are not yet fused.
  9. Ring Fracture – Fracture encircling foramen magnum occurs due to fall from height.
  10. The motor cyclist may drive into the back of a large vehicle e.g. truck known as “UNDER- RUNNING”    or “TAIL- GATING
  11. Countercoup lesions: present in an area opposite to the side of impact. When moving head strikes a stationary object.
  12. Concussion: temporary unconsciousness as a result of blunt force impact to the skull.
  13. RAILWAY SPINE: Concussion of the spinal cord is k/a RAILWAY SPINE. (1) Occurs in railway & motor car collision & is known as ‘railway spine’. Also occurs due to dislocation/ fracture of vertebrae, damage by effusion of blood, bullet injury, all causing direct severe injury to the spinal cord. (2) Effects seen are- temporary paralysis, affecting arms & hands or bladder, rectum, lower extremities. (3) S/S- appear from few minutes to few hours, headache, giddiness, restlessness, sleeplessness, neurasthenia, weakness in the limbs, amnesia, loss of sexual power and derangement of the special senses. Paralysis recovers in 48 hours.
  14. Whiplash injury: due to violent acceleration or deceleration force. E.g. hyperflexion, f/b acute hyperextension in the region of C4-C6 vertebra leading to injury.
  15. Boxing injuries: repeated blow to the head produces small hemorrhages and degenerative changes in the brain. fracture of skull is rare but subdural hemorrhage occurs commonly, it can lead to parkinsonism like sym. k/a DEMENTIA PUGILISTICA or PUNCH DRUNK SYNDROME (deterioration of speed and co-ordination)
  16. Intra Cranial Hemorrhage


1. Causes

i.  Trauma

ii.  rupture of Ant.

2. Vessal Involved
Branch of Middle meningeal A.

3. Lucid interval

4. Heat haematoma     resembles EDH


1. Causes

 i. Trauma

 ii. Rupture of

2. Vessal Involved
Bridging veins

3. Seen in –

     a. Trauma

     b. Chronic alcoholic

     c. Old age



 i. Trauma

 ii. Rupture of berry aneurysm



1. Most common site is putamen

2. Vessal Involved

Rupture of lenticulo-striate branch of middle cerebral A. (CHARCOT’S A.)

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