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The mechanisms for injury for AHT include two aspects of intracranial injury that occur when an immature head moves back and forth. First, one has to recognize that the brain itself is subjected to forces which make in move within the skull, causing direct trauma to brain cells , also called the “coup” injury, as well as secondary trauma, the “contrecoup” injury, as the brain recoils. These are shown by the large arrows. Second, this movement of the brain pulls on the vascular and ligamentous connections to the skull that, with enough force, are torn and result in bleeding, noted here by the small arrows.