Obvious head injury: analyzing the mechanism.

摘要

This 15-year-old male was in the back of a pick-up truck that was involved in a motor vehicle accident. The patient was ejected from the box of the truck. There were no specific details about the injury other than the ejection. When the emergency medical services arrived, they found the patient on the ground, nonrespon-sive and with what seemed to be a significant head injury. There was a large hematoma over the right occipital region of the skull.The patient was brought to our emergency room ER and it was immediately apparent that a significant neurologic injury had been sustained; the patient was not coherent or responsive. No other obvious injury was present except for a minor bruise to the left elbow. The blood pressure and pulse were stable. A CT study of the brain without contrast and a CT study of the abdomen and pelvis with contrast were obtained. The latter study was completely normal, but the CT study of the head was distinctly abnormal. Selected images of the head CT study are presented in Figure. 1. The abnormalities are obvious, but think of the mechanism of injury that led to these abnormalities.