Have you ever been in a car accident, collided with another person while playing a contact sport, or fallen from a high elevation? If you have, then you have probably sustained a concussion.
What are cerebral contusions?
● Cerebral contusions are a form of traumatic brain injuries (TBIs).
● These contusions are bruising of the brain tissue caused by multiple microhemorrhage of the small blood vessels leaking on the brain.
● Brain tissue swelling can be dangerous. Increased intracranial pressure requires emergency surgery (craniotomy) to help alleviate the pressure in the brain.
● If you suspect yourself or someone else of having a brain contusion, please seek medical attention immediately.
Causes
● Direct blunt force trauma by a solid object
● Motor vehicle accident
● Falling and hitting your head
● Being punched or kicked in the head
Symptoms
● Decline in mental function
● headaches
● confusion
● sleepiness
● dizziness
● loss of consciousness
● nausea
● vomiting
● seizures
● difficulty with coordination of movements
● ringing in the ear
● short-term memory loss
● difficulty seeing, speaking, hearing, and managing emotions
These symptoms depend on the severity and location of the brain injury (ies).
Diagnosis
● A computed tomography (CT) of the brain is the preferred imaging used to detect and assess intracranial hematomas (bleeding) and contusions.
o If the finding of the CT is good, with no significant signs of injury, then no surgical management is pursued.
Treatment
● close observation of physical and mental activity to determine treatment
● constant blood pressure monitoring and neurological exams every 2 hours
● repeat of imaging every 6 hours until images are stable
● anti-seizure medication
● close monitoring of patients to prevent hypotension (low blood pressure), hypertension (high blood pressure), hyponatremia (low sodium), and hypercapnia (increased CO2 levels in the blood caused by abnormal respirations)
Recovery
● Recovery depends on the initial Glasgow Coma Scale (GCS), the size and location of the contusion, the age of the patient, CT brain results, and surgical versus non-surgical treatment.
Notes
● The Glasgow Coma Scale (GCS) scores patients’ neurological function based on their clinical symptoms.
● The GCS measures three functions: eye movement, verbal response, and motor response.
● The initial GCS and the severity of the TBI help predict the probability of death from the injury.
● Mortality (death) rates increase the more the GCS score decreases.
o According to the GCS, total scores that range between 13-15 represent mild,
o range between 9-12 is moderate,
o and a GCS of 8 and below is classified as a severe TBI.
Long-term effects of a brain contusion
● Mild TBIs may cause concussions and patients may have dementia later in life as a result.
● Mild to moderate symptoms usually reverse within a few days to weeks after the injury.
● Sometimes injuries can produce long-term cognitive and behavioral deficits.
● Consequently, patients who have repeated mild TBIs can have chronic traumatic encephalopathy (CTE).
● Severe TBIs may have significant risk factors that can be the source of Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS).
References
Eli, I., Couldwell, M., and Rabb, C.H. (2019). Traumatic Intracerebral Contusions. https://books.google.com/books?hl=en&lr=&id=0MHADwAAQBAJ&oi=fnd&pg=PA53&ots=EL6ZWtMtEo
&sig=a40QHBSMJB3IFp_J5-5pQvjxlMU#v=onepage&q&f=false.
Tomatheart. (2019). CT brain scan image of a recent traumatic brain injury patient showing brain
contusion and hemorrhage at frontal load with subarachnoid bleeding at the base of skull. [CT brain
image]. https://www.shutterstock.com/image-photo/ct-brian-scan-image-recent-traumatic-1409233616.