Disorders of the…Skeletal System
Head and traumatic brain injuries are major causes of immediate death and disability, with bleeding and infections as possible additional complications. According to the Centers for Disease Control and Prevention (2010), approximately 30 percent of all injury-related deaths in the United States are caused by head injuries. The majority of head injuries involve falls. They are most common among young children (ages 0-4 years), adolescents (15-19 years), and the elderly (over 65 years). Additional causes vary, but prominent among these are automobile and motorcycle accidents.
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Strong blows to the cranium can produce fractures. These may result in bleeding inside the skull with subsequent injury to the brain. The most common is a linear skull fracture, in which fracture lines radiate from the point of impact. Other fracture types include a comminuted fracture, in which the bone is broken into several pieces at the point of impact, or a depressed fracture, in which the fractured bone is pushed inward. In a contrecoup (counterblow) fracture, the bone at the point of impact is not broken, but instead a fracture occurs on the opposite side of the skull. Fractures of the occipital bone at the base of the skull can occur in this manner, producing a basilar fracture that can damage the artery that passes through the carotid canal.
A blow to the lateral side of the head may fracture the bones of the pterion. The pterion is an important clinical landmark because located immediately deep to it on the inside of the skull is a major branch of an artery that supplies the skull and covering layers of the brain. A strong blow to this region can fracture the bones around the pterion. If the underlying artery is damaged, bleeding can cause the formation of a hematoma (collection of blood) between the brain and interior of the skull. As blood accumulates, it will put pressure on the brain. Symptoms associated with a hematoma may not be apparent immediately following the injury, but if untreated, blood accumulation will exert increasing pressure on the brain and can result in death within a few hours.
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