Stephen J. Schueler, M.D.

Head Injury Anatomy

To better understand head injury, it helps to understand the anatomy of the brain.

The brain is well protected by:

  • The scalp
  • The skull
  • The dura
    • A tough 3-layer sheath that surrounds the brain and spinal cord
    • Layers include the dura mater (strongest layer), arachnoid mater (middle layer), and pia mater (closest to the brain)

The brain is a complicated structure containing many parts. These include:
  • The cerebrum:
    • Made up of two cerebral hemispheres that are connected in the middle
    • It is the largest part of the brain
    • Each area of the cerebrum performs an important function, such as language or movement
    • Higher thought (cognition) comes from the frontal cortex (front portion of the cerebrum)
    • Outside of the cerebrum are blood vessels
    • There are fluid-filled cavities and channels inside the brain
  • The cerebellum:
    • Located in the lower, back part of the skull
    • Controls movement and coordination
  • The brainstem and pituitary gland:
    • Responsible for involuntary functions such as breathing, body temperature, and blood pressure regulation
    • Pituitary gland is the "master gland" that controls other endocrine glands in the body, such as the thyroid and adrenal glands
    • Pineal gland
  • The cranial nerves:
    • Twelve large nerves exit the bottom of the brain to supply function to the senses such as hearing, vision, and taste
  • The cerebral blood vessels:
    • A complicated system that supplies oxygenated blood and nutrients to the brain

The blood supply to the brain is divided into two main parts:
  • Anterior cerebral circulation:
    • The front of the brain is supplied by the paired carotid arteries in the neck.
  • Posterior cerebral circulation:
    • The back portion of the brain is supplied by the paired vertebral arteries in the spine.

Anatomy examples:
  • Carotid artery branches shown on arteriogram
  • Cerebral arteries viewed in cross-section through middle of brain
  • Cerebral arteries viewed from bottom of brain
  • Cerebral arteries on enhanced CT scan
  • Cerebral arteries on arteriogram

Last Updated: Dec 14, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Head Injury References
  1. Edwards P, Arango M, Balica L, et al. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005 Jun 4-10;365(9475):1957-9. [15936423]
  2. Grappling with traumatic brain injury. Lancet. 2007 Dec 8;370(9603):1879. [18068492]
  3. Lee AC, Ou Y, Fong D. Depressed skull fractures: a pattern of abusive head injury in three older children. Child Abuse Negl. 2003 Nov;27(11):1323-9. [14637305]
  4. McKinley J. New challenges in assessing and managing concussion in sports. Am Fam Physician. 2007 Oct 1;76(7):948-9. [17956064]
  5. Ropper AH, Gorson KC. N Engl J Med. 2007 Jan 11;356(2):166-72. Review. No abstract available. Erratum in: N Engl J Med. 2007 Apr 26;356(17):1794. [17215534]
  6. Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. [16189365]
  7. Tender GC, Awasthi D. Risk stratification in mild head injury patients: the head injury predictive index. J La State Med Soc. 2003 Nov-Dec;155(6):338-42. [14750754]
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