Traumatic brain injury (TBI) is caused by two mechanisms, impact, and movement of the brain inside the skull.
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In either case, mechanical forces transmitted to the underlying brain, compress or lacerate its surface and cause ripples of shock waves that travel through it and injure parts remote from the impact.
The tentorium holds the brainstem and cerebellum tight in the posterior fossa.
Spontaneous subdural haematoma in a paediatric patient on anticoagulant therapy.