Aspects on pathology and neuropathology in head injury

Some principal differences of the head injury materal available to clinicians, hospital pathologists and forensic pathologists are discussed with reference to the primary and secondary findings at focal and diffuse brain injury and intracranial injuries after trauma. The importance of cooperative understanding between the different disciplines is stressed in order to cover the whole head injury pattern. Examples are given. The importance of intracranial arterial hemorrhages is stressed and may also be the cause of a particular group of acute subdural hematomas; it may be of special prognostic importance because of their probable availability to successful surgery in the acute stage. The cause may be a tearing of arterial connections between the peripheral branches of the middle cerebral artery and the dura. The diagnosis of different types of primary diffuse brain injury is discussed with particular reference to the non-satisfactory common histological methods of investigation early after trauma. Diffuse brain injury due to hypoxia at the trauma can be serious but give few macroscopical findings; disseminated intravasal coagulation can appear isolated in the brain or be part of a systemic manifestation.