Closed craniocerebral injury formation according to an indirect mechanism: a case from expert practice

Background: Approximately, 50 thousand die (i.e., about 10%) out of the 600 thousand people with a head injury. Literature examples reported some cases with brain damage with membranes in closed craniocerebral trauma formed by an indirect mechanism without direct contact of blunt solid objects in the head, which is characteristic of impulse trauma. Case presentation: In our practice, an unusual case of an indirect closed craniocerebral trauma with a fatal outcome resulting from a road traffic accident was encountered. The forensic medical examination of the corpse established a traumatic brain injury that formed without direct contact with blunt solid objects in the head. Traumatic brain injury formation by an impulse mechanism is rare in forensic medical practices; therefore, each case of such an injury is of certain interest, both in practical and scientific terms.

Conclusion: The impulse mechanism of head trauma, combined with the shock mechanism in road traffic accidents, is much more common than is currently believed. The bleeding source in such cases is often the venous vessels of the cerebral hemispheres, which flow into the sagittal sinus of the dura mater.