If the address matches an existing account you will receive an email with instructions to reset your password. If the address matches an existing account you will receive an email with instructions to retrieve your username. The magnitude of damage to cerebral tissues following head trauma is determined by the primary injury, caused by the kinetic energy delivered at the time of impact, plus numerous secondary injury responses that almost inevitably worsen the primary injury. When head trauma results in a cerebral contusion, the hemorrhagic lesion often progresses during the first several hours after impact, either expanding or developing new, non-contiguous hemorrhagic lesions, a phenomenon termed hemorrhagic progression of a contusion HPC. Because a hemorrhagic contusion marks tissues with essentially total unrecoverable loss of function, and because blood is one of the most toxic substances to which the brain can be exposed, HPC is one of the most severe types of secondary injury encountered following traumatic brain injury TBI. Historically, HPC has been attributed to continued bleeding of microvessels fractured at the time of primary injury.
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They are usually characterized on CT as hyperdense foci in the frontal lobes adjacent to the floor of the anterior cranial fossa and in the temporal poles. Contusions, by definition, result from head trauma and are thus seen more frequently in young males. Typical causes include motor vehicle accidents or situations in which the head strikes the ground.
Most contusions represent the brain coming to a sudden stop against the inner surface of the skull contrecoup accentuated by the natural contours of the skull see below. Cerebral contusions can occur anywhere, but have a predilection for certain locations, as a result of the direction of the head strike and the intrinsic shape of the skull cavity.
Typically cortical contusions become more apparent on follow-up imaging due to further bleed or surrounding edema. Hence on follow-up CT scans in the first couple of days after trauma, one may detect the increase in number and size of the lesions but the patient may not show any clinical deterioration. Furthermore, the appearance of contusions will vary according to when they are imaged. Typically they mature over some weeks, initially appearing as merely hemorrhagic foci, followed by the development of surrounding edema, before gradually fading away leaving behind more or less distinct areas of gliosis.
In most hospitals, CT is usually the first and often the only investigation used to assess cerebral contusions. So blood should be hyperdense in comparison to grey or white matter. Of note, in anemic patients i. A pitfall is missing a small contusion near the skull base , which can be overseen on CT scans due to partial volume averaging. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
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Please use another browser until we can get it fixed. On this page:. Quiz questions. Post-operative expansion of hemorrhagic contusions after unilateral decompressive hemicraniectomy in severe traumatic brain injury. Edit article Share article View revision history Report problem with Article. URL of Article. Article information. Systems: Central Nervous System , Trauma.
Tags: emergencymedicine , trauma , core condition. Synonyms or Alternate Spellings: Cerebral haemorrhagic contusions Haemorrhagic cerebral contusion Haemorrhagic cerebral contusions Intracerebral haemorrhagic contusions Haemorrhagic intracerebral contusion Cerebral hemorrhagic contusion Hemorrhagic cerebral contusion Hemorrhagic cerebral contusions.
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Hemorrhagic Progression of a Contusion after Traumatic Brain Injury: A Review
They are usually characterized on CT as hyperdense foci in the frontal lobes adjacent to the floor of the anterior cranial fossa and in the temporal poles. Contusions, by definition, result from head trauma and are thus seen more frequently in young males. Typical causes include motor vehicle accidents or situations in which the head strikes the ground. Most contusions represent the brain coming to a sudden stop against the inner surface of the skull contrecoup accentuated by the natural contours of the skull see below.
Cerebral contusion , Latin contusio cerebri , a form of traumatic brain injury , is a bruise of the brain tissue. Contusions are likely to heal on their own without medical intervention. The symptoms of a cerebral contusion depend on the severity of the injury, ranging from minor to severe. Individuals may experience a headache, confusion, sleepiness, dizziness, loss of consciousness, nausea and vomiting, seizures, difficulty with coordination and movement, lightheadedness, tinnitus, and spinning sensations. They may also have difficulty with memory, vision, speech, hearing, managing emotions, and thinking. Often caused by a blow to the head, contusions commonly occur in coup or contre-coup injuries. In coup injuries, the brain is injured directly under the area of impact, while in contrecoup injuries it is injured on the side opposite the impact.
Contusiones y laceraciones cerebrales