Clinical analysis of seven patients of crushing head injury.
BACKGROUND
Crushing head injuries (CHI) are caused by static loading. This static force slowly deforms a cranium and damages some intracranial components. Severe CHI is usually fetal but substantial brain damage may not be recognized in some patients. In this article, we report seven patients who sustained CHI and analyzed clinical and radiological findings.


METHODS
In seven patients who sustained CHI, the following factors were analyzed: epidemiological features, neurological findings, and neuroradiological findings.


RESULTS
The present series included three males and four females. Mean age was 5.9 years. Six patients had the heads run over by automobiles. One patient had the head crushed by press machine. Epistaxis in six patients and otorrhagia in five patients was recognized. Mean Glasgow coma scale at admission was 8.1. Multiple linear fractures were recognized in four patients and skull base fractures in six patients. Pneumocephalus in five patients and cerebrospinal fluid leakage in seven patients was recognized. One patient underwent evacuation of ASDH and dural plasty. Four patients died and three survived and had only cranial nerve palsies, which recovered completely.


CONCLUSIONS
This injury actually has seldom been countered in daily practice and clinical manifestation and neuroimaging have characteristic features. The prognosis of CHI may be polarized to fatal or excellent, and depends on whether the cranium and brain itself can tolerate the applied force.
Takeshi
Matsuyama
M
Nara Medical University, Nara, Japan. tmatsuya@nmu-gw.naramed-u.ac.jp
Okuchi
Kazuo
K
Nishiguchi
Takashi
T
Seki
Tadahiko
T
Watanahe
Tomoo
T
Ito
Shingo
S
Murao
Yoshinori
Y
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003389:Cranial Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000209:etiology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing