Cerebral Contusion

What Is It?

A cerebral contusion is basically a bruise of the brain. Just like elsewhere on your body, if enough force is applied in a trauma, the tissue can become damaged and swollen and blood vessels within the tissue can break, leading to oozing of blood into the tissue (which is what causes the black and blue appearance of a bruise).

When a traumatic brain injury occurs, the brain moves around inside the skull. Either the direct impact or the sloshing of the brain and hitting the inner part of the skull can cause this type of injury to the brain. The brain tissue itself is quite fragile and easily injured. With enough force applied to the head, the brain can hit the side of the skull, leading to a cerebral contusion.

A brain contusion is often associated with what is called a contra coup injury. The coup is the primary impact on the head, caused by whatever hit the head during the trauma. When this force is applied, as mentioned above, the brain slides back and forth inside the skull, frequently hitting the bone on the other side of the head. Therefore, the contra coup is often roughly opposite the side of the initial impact. Overall, because of the contour of the skull and the way the brain sits on it, the most common location for these contusion injuries is in the area of the temporal lobes and lower frontal lobes.

What Types of Symptoms Are Typical?

The symptoms associated with cerebral contusion vary widely depending on patient factors, other coexistent traumatic injuries and the size and severity of the contusion. Frequently, significant contusion is associated with other traumatic brain injury and thus the clinical presentation of the patient is the result of multiple pathologies. If a contusion is big enough, it can cause significant swelling and resultant increase in intracranial pressure. Many patients with significant head injury will have some degree of depression of their level of consciousness. This is often described or graded by the Glasgow Coma Scale

How Is The Diagnosis Typically Made?

As with most traumatic brian injuries, a cerebral contusion can be visualized on a CT scan. This imaging study will clearly show patchy blood in the brain tissue as well as swelling in the area. As mentioned previously, oftentimes these injuries are accompanied by other findings as well.

What Are Some Common Treatments?

Treatment varies considerably depending on many factors. While smaller contusions may be simply watched, large contusions may require surgical excision or decompression. The decision making process involves many factors including patient characteristics, other brain injuries, symptoms and level of consciousness. Therefore, no generalizations can be made about what is appropriate for every contusion.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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