Rotational head trauma with callosal contusion and C6 fracture: A high-speed motorcycle accident

Abstract

We present the case of a 34-year-old Albanian male who was riding a motorcycle when he collided at high-speed with a four-wheel vehicle. After a triple pivotal rotation in the air at the moment of impact, he fell from the motorcycle to the ground. The clinical picture thereafter was one of deep coma, treated in the intensive care unit for nine days, until he regained consciousness and long-term rehabilitation procedures were put in place. The magnetic resonance and computed tomography images were very illustrative of a rotational head trauma mechanism, since in addition to multiple callosal hemorrhages and the lack of cranial fractures, a linear complex fracture of the C6 vertebra was seen, justifying orthopedic treatment through immobilization of the cervical spine. Rotational angular acceleration seems to be an important causative factor toward provoking diffuse brain and/or axonal injury; the etiological importance on the direct skull impact is controversial, but in any case not negligible.