What Is a Brain Contusion?

Cerebral contusion is a closed brain injury in which the shape of the cerebral cortex is preserved while the bleeding and / or swelling is substantial. When the head is hit by a blunt device or a traffic accident, a high fall, and the head collides with other objects, the head performs linear acceleration, linear deceleration, or rotational movement. At this time, the brain tissue and the skull move at different speeds; Collision of the inner skull plate; or sliding on the skull base plate with uneven height; or shear force due to the inconsistent movement speed of various parts of the brain; or direct injury to the fracture area or compression of the brain hernia, brain parenchyma may occur Contusion (fracture) injury. ^[1]

Brain contusion

Cerebral contusion is a closed brain injury in which the shape of the cerebral cortex is preserved while the bleeding and / or swelling is substantial. When the head is hit by a blunt device or a traffic accident, a high fall, and the head collides with other objects, the head performs linear acceleration, linear deceleration, or rotational movement. At this time, the speed of the brain tissue is not consistent with that of the skull; or it is rough and uneven. Collision of the inner skull plate; or sliding on the skull base plate with uneven height; or shear force due to the inconsistent movement speed of various parts of the brain; or direct injury to the fracture area or compression of the brain hernia, brain parenchyma may occur Contusion (fracture) injury. ^[1]

Cerebral contusion: A common primary brain injury in which the pia mater formed by external forces is intact and the superficial hemorrhage and / or contusion of the cerebral cortex. It is mainly formed by the brain tissue performing linear acceleration or deceleration movement or rotation movement in the skull after the external force acts, and the brain surface collides with and rubs against the inside surface of the skull or the base of the skull.

1. The disturbance of consciousness is more serious, lasts longer, and even coma persists to death after injury.

2. After the recovery of consciousness, there are many headaches, brain irritation and obstacles to application function.

3.There are often obvious autonomic nerves (

When non-surgical treatment is the main, a series of pathologies after brain injury should be minimized

1. X-ray plain film: If the injury allows, X-ray skull plain film examination still has its important value. It can not only understand the specific situation of the fracture, but also have special significance for analyzing the injury mechanism and judging the injury. .

2. CT scan: A clear differential diagnosis of cerebral contusion and concussion can be made, and it can clearly show the location, degree and the presence of secondary damage such as bleeding and edema. At the same time, the intracranial pressure can be estimated indirectly according to the size, shape and displacement of the ventricles and cerebral cisterns. It is particularly important that for some atypical cases, the evolution of cerebral edema or the occurrence of delayed hematoma can be dynamically observed through periodic CT scans.

3, MRI (magnetic resonance imaging): generally less used in the diagnosis of acute craniocerebral injury. MRI imaging takes a long time, some metal emergency equipment cannot enter the computer room, and it is difficult for patients with restlessness to cooperate. Therefore, CT is the first choice. However, in some special cases, MRI is better than CT, such as the display of the brain stem, corpus callosum, and cranial nerves; the display of micro-brain contusion, axonal injury and early cerebral infarction; and the hematoma at the density stage such as CT In terms of display and differential diagnosis, MRI has its own unique advantages that CT does not.

4. Lumbar puncture: It helps to understand the blood content of cerebrospinal fluid, which can be distinguished from concussion. At the same time, it can measure intracranial pressure and drain cerebrospinal fluid. However, for patients with significant intracranial hypertension, lumbar puncture examinations should be contraindicated to prevent the occurrence of cerebral hernia.

5. Other auxiliary examinations: such as cerebral angiography, which is now rarely used, but in hospitals or areas where CT is not yet available, it must still rely on cerebral angiography to assist diagnosis; EEG examinations are mainly used to judge prognosis or The monitoring of epilepsy; the brainstem auditory evoked potential examination has important reference value for analyzing the degree of brain function impairment, especially for judging the level of brainstem injury. In addition, radionuclide examination is of great value for the later complications of cerebral contusion and laceration, such as vascular embolism, arteriovenous fistula, cerebrospinal fluid leakage and hydrocephalus.

Methods for treating craniocerebral injury include "common surgical treatment, stereotactic intracerebral hematoma puncture and drainage, mild hypothermia treatment, neurotrophic medication, and cranioplasty". Experts use these technologies to specifically treat patients with craniocerebral injury, and the treatment effect Well, the prognosis is good.