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BRAIN HAEMATOMA

Anatomy of Skull

 The skull consists of two set of bones:

 The cranial bones that form the neurocranium, which lodges the brain.

 The facial bones, which form the viscerocranium. The bones of the isceral

crani!m form the orbits, the oral cait" and nasal one.

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Basal as#ect of s$!ll

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  Haematoma in the

ictim

%. The e&act location of the haematoma:

In this case, from the #reio!s #ict!re of the brain haematoma, the location

of the haematoma is in the tem#oral region. 'rom the #ict!re the haematoma

is #redicted to be in s!bd!ral or s!barachnoid s#ace. B!t, from the #hoto, we

can see the haemorrhage #ass thro!gh the g"r!s of the brain and therefore

the most #ossible location of the haematoma is in the s!barachnoid s#ace.

(. The ca!se of the brain haematoma:

 This brain haematoma is d!e to bl!nt force tra!ma. There is #robabl" a

fract!re in)!r" that ca!sed the blood essel to be torn and conse*!entl"

leads to haematoma. That s$!ll fract!res commonl" occ!r when indiid!als fall on the bac$ of the

head becomes obio!s when one reali+es that a freefall of - ft for a head

weighing % lb gies an aailable energ" of - ft lb, well within the range

necessar" to #rod!ce a linear fract!re of  

the s$!ll if it im#acts an !n"ielding s!rface. The elocit" of the head at the

time of im#act is a##ro&imatel" ( ft/s or %0.1 m#h.

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'alls remain one of the most common mechanisms across the age gro!#s,

with the highest occ!rrence in children and the elderl". 'alls can be as sim#le

as tri##ing or sli##ing on a wet s!rface to falls from signi2cant height, li$e

#arach!tes and b!ngee )!m#ing, that res!lt in seere in)!ries. 3iing in)!ries

ma" not be ca!sed b" a high fall4 howeer the" inole the stri$ing of thehead/nec$ on the bottom s!rface res!lting in h"#er5e&ion. Other falls incl!de

falling downstairs, o6 #la"gro!nd e*!i#ment, or sim#l" o6 a c!rb, or more

serio!s intentional in)!ries, li$e )!m#ing from a balcon" or bridge. The

mechanics of the fall and the #osition of landing gie cl!es to the in)!ries

s!stained. In the case of intentional in)!r", #s"chiatric s!##ort m!st be

antici#ated in addition to identif"ing and managing the in)!ries. 7ro!nd leel

8im#le gro!nd leel falls 97'; ha##en to all age gro!#s, howeer in)!r"

occ!rs more often in the elderl" as the bones are more fragile. It is not

!ncommon for a gro!nd leel fall with a

hi# fract!re to #rogress to a serio!s decrease in f!nction and #ossibl" death.

!mbar ertebra in)!ries are common as well as cerical s#ine in)!r" from

h"#er5e&ion of the nec$. Most 7' res!lt in fract!res or head in)!r"

de#endent !#on the s!rface and if a shar# or bl!nt ob)ect is str!c$ on the

wa" to the gro!nd. In the elderl", a s!bd!ral hematoma is not !ncommon.

0. The relation between haematoma that conse*!entl" ca!se bleeding in the

ear and nose:

 The haematoma is most #robabl" ca!sed b" fract!re of the basal cranialis. In

basal cranialis there is a foramen called foramen lacer!m, which is a

triang!lar hole in the base of the s$!ll located at the base of the medial

#ter"goid #late. The arter" that #assed thro!gh this foramen is the internal

carotid arter", which #asses s!#eriorl" from the carotid canal4 in the base of 

the s$!ll. The internal carotid arter" is arises from common carotid arter".

Ac!te in)!r" to the internal carotid arter" 9carotid dissection,

occl!sion, #se!doane!r"sm formation almost e&cl!siel" obsered when

the carotid canal is fract!red, altho!gh onl" a minorit" of carotid canal

fract!res res!lt in asc!lar in)!r". Inolement of the #etro!s segment of the

carotid canal is associated with a relatiel" high incidence of carotid in)!r". <=>

A s$!ll fract!re is a brea$ in one of the bones of "o!r head. A fract!re ma" bea hairline crac$, or it can be what is called a de#ressed fract!re. A s$!ll

fract!re can in)!re the brain. 8$!ll fract!res can be ca!sed b" falls, b"

#enetrating in)!ries from e&ternal ob)ects, 9s!ch as g!nshot wo!nds or

wo!nds from $nies, hammers, or a&es;, or as the res!lt of the s$!ll forcef!ll"

hitting a solid ob)ect. A brain in)!r" ma" be #resent with a s$!ll fract!re. The

fract!re can hel# #roide cl!es abo!t the area of the brain in)!red and the

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seerit" of the in)!r". Br!ising or discoloration that deelo#s within (? ho!rs

after a head in)!r" ma" be ca!sed b" a fract!re at the base of the s$!ll

9basilar s$!ll fract!re;. A basilar s$!ll fract!re often occ!rs with bleeding

within the s$!ll. Bleeding from the ears or the nose that is not ca!sed b" a

c!t or a direct blow ma" indicate a fract!re of the base of the s$!ll. @ash theblood from the c!t and s!rro!nding area to hel# determine if the bleeding is

coming from a c!t in that area. 8igns of a basilar s$!ll fract!re ma" a##ear as

br!ising behind one ear 9Battles sign; or br!ising aro!nd both e"es 9raccoon

e"es;. A basilar skull fracture 9or basal skull fracture; is a fract!re of the

base of the s$!ll, t"#icall" inoling the tem#oral bone, occi#ital

bone, s#henoid bone, and/or ethmoid bone.