Morphology of the Sequelae of Increased Intracranial Pressure

With the introduction of the concept of primary and secondary brain injuries, it became clear that the outcome of one particular cranial-cerebral injury greatly depends on the secondarily initiated mechanisms, which are actually resulting of raised intracranial pressure (ICP). We can conclude about the existence of the raised ICP during person was alive, at the postmortem examination only by its effects on the brain tissue i.e. the signs of internal herniation as sequelae of it. This paper discusses our findings on the sequelae of raised ICP based on neuropathological examination of 80 forensic cases of closed head injury with a survival until 1,5 month. Our findings indicate that the herniation of the brain is going to occur in the first 10,5 days in 90% of the cases and in nearly half of them this deadly consequence can occur in the first 48 hours, which is of great clinical importance.