The concept of inner cerebral trauma.

Abstract

The pattern of "inner cerebral trauma" is a morphological and functional-pathological correlate of biomechanical conditions at the event of severe closed craniocerebral injury of acceleration-type, if the traumatizing forces act in the direction of the longest diameter of the skull. The lesions are characteristically localized in the "centro-axial" regions of the brain involving most frequently: corpus callosum, septum pellucidum, fornix, tela chorioidea, peri- and para-ventricular zone, infundibulobasal region and cingulum; this pattern also includes lesions of the hippocampal area, upper brainstem, pontocerebellar complex, and parasagittal areas of the cerebrum. This pattern includes lesions, which are from the onset "primary irreversible" as well as "primary reversible" lesions, which spread apart from the "epicentres" of the primary irreversible damage and are in principle more diffuse but still within the basic pattern of the main predilection. This is the basis of the process of "traumatic cerebral disease". The final size and scope of the pathological process of the "traumatic cerebral disease" depend on a number of secondary factors, which may allow the normal process of healing to keep the tissue changes within the initial scope of "primary irreversible damage", or may enhance a progressive process of turning the "reversible" traumatic damage into the irreversible lesions.