Dynamic mechanism of severe head injury was studied and analyzed clinically with special reference to the brain damage and the outcome of it in 149 cases, in which more accurate mechanism of severe head injury could be informed during these three years. The outcome of the head injury had a significant correlation with the occurrence of intracranial lesion, especially with the degree and extent of the brain damage, and the severity of consciousness disturbance was most important as the clinical presentation of the brain damage and had a relation to the prognosis. Dynamic assessment performed in the present series showed that the dynamic force and direction closely related to the occurrence of intracranial lesion, especially brain damage. In other words, fatal brain injury such as diffuse brain injury or brain stem injury occurred when an extremely severe force was delivered on the head. It was suggested that a rotational accelerating force and shearing force to the he ad would be most important as the characteristics of dynamic force in the development of severe brain damage. In the present report, the above mechanism was discussed. Not only clinical and morphological assessment by CT but also dynamic assessment of the head injury has much more value for the diagnosis, prediction of the outcome, and treatment.
