Cushing's Classification of Penetrating Head Injuries During World War I

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.

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