This increased intracranial pressure can compress other blood vessels and cause damage to brain tissue. Surgical shunts can bypass the blocked aqueduct and return CSF directly to venous blood vessels to alleviate the problem. The third meningeal layer, pia mater , lies directly on the surface of the brain and cord and is the innermost layer. Although effective, the protection afforded by the meninges and CSF is not absolute. Impacts to the head can cause the suspended brain to shift within its CSF environment and strike the inner cranium to cause damage.
Damage caused by such head impacts is often characteristically in two directly opposite locations.
Consequently, head injured clients should be assessed for both potential injury sites. Concussion A concussion results from sudden movement or shaking of the brain within the cranium and can cause multiple sites of injury varying in the degree of severity with the causative force. Since concussions damage soft tissue of the brain, they do not appear on diagnostic scans. One unfortunate consequence of multiple concussions is their additive effect. This situation is most familiar when it occurs in athletes.