CEREBRAL CONTUSION


■ Usually frontal/temporal lobes
■ Contusion may be at side opposite to injury - "contrecoup"


  TYPE OF PATIENT ANATOMIC LOCATION CT FINDINGS COMMON CAUSE CLASSIC SYMPTOMS
Epidural Most common in young adults, rare in the elderly Potential space between skull and dura mater Biconvex, football-shaped hematoma Skull fracture with tear  of the middle meningeal artery Immediate LOC with a "lucid" period prior to deterioration (only occurs in about 20% of patients)
Subdural More risk for the elderly & alcoholics Space between dura mater and arachnoid Crescent- or sickle-shaped hematoma Acceleration - deceleration with tearing of the bridging veins Acute: Rapid LOC - lucid period possible
Chronic: Altered MS & behavior with gradual decrease in consciousness
Subarachnoid Any age group following blunt trauma. Subarachnoid Blood in the basilar cisterns & hemispheric sulci & fissures Acceleration-Deceleration w/ tearing of the subarachnoid vessels Milt to moderate TBI w/ meningeal signs & symptoms
Contusion/
intracerebral hematoma
Any age group following blunt trauma. Usually anterior temporal or posterior frontal lobe May be normal initially with delayed bleed Severe or penetrating trauma, shaken-baby syndrome Symptoms range from normal to unconscious.
Abbreviations: LOC = loss of consciousness; MS = mental state; TBI = traumatic brain injury.