Which trauma is associated with cranial strain pattern #4?

• A. Right torsion
• B. Left torsion
• C. Superior vertical strain
• D. Left lateral strain

Answer: (A)

Cranial strains arise from how the sphenoid and occiput move relative to one another after a traumatic event. Pattern four is a torsional strain, meaning the sphenoid and occiput rotate in opposite directions about the sagittal (SBS) axis. When this pattern is right-torsion, the sphenoid rotates to the right while the occiput rotates to the left.

A twisting injury to the head—such as a rotational/torqueing force from a fall or blow that twists the head—tavors this rightward rotation pattern. That’s why right torsion is the best match for pattern four: it reflects a rotational trauma that ends with the sphenoid turning right relative to the occiput.

If the trauma were a vertical impact, you’d expect a superior vertical strain; if it were a lateral impact, a lateral strain; and if the rotation were to the left, you’d have left torsion.