Clinical features of low-velocity, crushing head injury;A report of 6 cases

Abstract

Head injuries produced by static loading mechanisms have been called low-velocity, crushing head injuries (CHI). If the injury is not fatal, there is usually no severe disturbance of consciousness, but CHI are characterized by damage to the cranial nerves caused by traction, stretching, and fractures of the cranial base due to the distortion of the skull. In this paper, we report on six cases of low-velocity CHI. There were four adults and two pediatric cases (less than five years of age). Cranial nerve palsy was observed in five cases. Skull base fractures traversing the clivus were recognized in four cases, optic canal fractures in two cases, and carotid canal fractures in two cases. The final neurological outcomes were as follows: full recovery (three cases), and minor (two cases) and severe (one case) morbidity. CHI is a rare condition with a unique injury mechanism and clinical symptoms. CHI patients present with a variety of cranial nerve injuries caused by distortion of the cranial base and the distribution of basilar skull fractures. In occupational accidents in adults and traffic accidents in children, CHI caused by static loading forces should be considered, and proper imaging studies are necessary to make an accurate diagnosis. (JJAAM. 2012; 23: 415-20)