Cushing classified penetrating head injuries based on his experiences during World War I.
Scalp |
Skull |
Dura |
Other |
Grade |
laceration |
intact |
intact |
with or without cerebral contusions |
I |
NA |
fracture |
intact |
skull fracture may or may not be depressed |
II |
NA |
fracture |
laceration |
skull fracture depressed |
III |
NA |
fracture |
penetrated |
indriven bone fragments, brain usually extruding |
IV |
penetrated |
penetrated |
penetrated |
projectile lodged in brain, brain usually extruding |
V |
penetrated |
penetrated |
penetrated |
ventricles penetrated by bone fragments |
VIA |
penetrated |
penetrated |
penetrated |
ventricles penetrated by projectile |
VIB |
penetrated |
penetrated |
penetrated |
orbitonasal or auropetrosal region, brain usually extruding |
VII |
penetrated |
penetrated |
penetrated |
severe cerebral injury |
VIII |
NA |
bursting fracture |
NA |
extensive cerebral contusion |
IX |
Mortality increases with injury grade.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general