Speed of development of cerebral swelling following blunt cranial trauma.

A 22-year-old male suffered severe injuries to the head, chest and abdominal cavities in a vehicle crash, with death occurring at the scene. At autopsy, the cranial cavity was opened and markedly disrupted with compound and comminuted fracturing of all bones of the skull and facial skeleton. The brain showed extensive lacerations with almost complete parenchymal disruption. However, a preserved fragment of right frontal lobe exhibited marked swelling with gyral flattening. This case could provide further evidence for prompt cerebral swelling after blunt head trauma, and is supportive of animal studies that have demonstrated rapid swelling that is most likely is related to reactive vasodilation rather than to vasogenic oedema.