Traumatic brain injury (TBI) is regarded as one of the most troubling forms of trauma, having in mind that about 50% of all survivors suffer from long-term physical, cognitive, emotional or behavioral sequelae [1]. Focal injuries of the brain occurring after interaction with the skull (most frequently with the inferior frontal lobes, frontal poles and the inferior temporal lobes) are known as contusions, which may be further complicated by herniation, hemorrhage, the formation of intracerebral hematomas, or laceration of the brain [2] [3]. Moreover, contusions are classified as coup or contrecoup lesions, suggesting whether the brain injury developed at the site of impact (coup) or at the opposite pole (contrecoup), often being more severe [2] [4]. Motor vehicle accidents are, by far, the most common cause of TBI and contusions, while blunt force trauma and sports activities are also important mechanisms of trauma [1] [4]. Regardless of the type of injury, the clinical presentation solely depends on its severity. Milder contusions usually do not cause any focal neurological deficits, while moderate and severe trauma can cause marked changes in the level of consciousness (lethargy, stupor, and coma are possible manifestations) and overall responsiveness of the patient [4] [5] [6]. One of the most important features of contusions is their frequent enlargement in the hours following the injury, leading to potentially severe and life-threatening neurological deterioration in the absence of an early diagnosis, suggesting that timely recognition of trauma and confirmation of a brain contusion is detrimental in order to achieve a good long-term outcome [5] [6].

• Epilepsy

  These plaques, also known as "plaque jaune", may be foci for subsequent epilepsy 10. [radiopaedia.org]

  Epilepsy in head trauma Epilepsy may be a sequela of head injury. [dartmouth.edu]

  […] cerebral cortex Laceration of cerebrum with loss of consciousness ICD-10-CM S06.339A is grouped within Diagnostic Related Group(s) (MS-DRG v 36.0): 023 Craniotomy with major device implant or acute complex cns pdx with mcc or chemotherapy implant or epilepsy [icd10data.com]

  TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age. 1 Repeated mild TBIs occurring over an extended period of time (i.e., months [biau.org]

• Asymptomatic

  Correlation between clinical and laboratory findings suggests that: X-ray examination is not predictive of CSF hemorrhage or brain contusion; the CSF is bloody in 1/3 of asymptomatic cases and in 1/6 of cases without fracture; the EEG shows indirect signs [ncbi.nlm.nih.gov]

  Grade 2 – Athletes can return to play once they are asymptomatic and have completed a return-to-play protocol, which is a five-stage gradual increase in activity. [brighamhealthhub.org]

• Impaired Balance

  They may also have vomiting, seizures, or impaired balance or coordination. The ability to think, control emotions, move, feel, speak, see, hear, smell, and remember may be impaired. [merckmanuals.com]

• Vomiting

  Symptoms Of Cerebral Contusions Vomiting, severe headaches, loss of memory, confusion, drowsiness, and weakness are all indications that one may have a cerebral contusion. [kirkendalldwyer.com]

  ~Nausea and vomiting. ~Weakness. Cerebral Contusion Assessment ~Physical Examination ~Decreased level of conciousness. [quizlet.com]

  Symptoms and signs associated with severe injury to the brain include excruciating headache accompanied by nausea and vomiting, increase in size or uneven size of the pupils of the eyes, long period of unconsciousness, confusion, agitation or tiredness [ic.steadyhealth.com]

  Nausea and vomiting accompanied with seizures. Difficulty in coordination of movements. Some individuals may also experience difficulty in hearing, vision or speech. [tandurust.com]

  Mild symptoms of a brain contusion can include a brief loss of consciousness, dizziness, feeling confused, headache, tiredness, and nausea and/or vomiting. [study.com]

• Nausea

  ~Nausea and vomiting. ~Weakness. Cerebral Contusion Assessment ~Physical Examination ~Decreased level of conciousness. [quizlet.com]

  Symptoms and signs associated with severe injury to the brain include excruciating headache accompanied by nausea and vomiting, increase in size or uneven size of the pupils of the eyes, long period of unconsciousness, confusion, agitation or tiredness [ic.steadyhealth.com]

  Nausea and vomiting accompanied with seizures. Difficulty in coordination of movements. Some individuals may also experience difficulty in hearing, vision or speech. [tandurust.com]

  Mild symptoms of a brain contusion can include a brief loss of consciousness, dizziness, feeling confused, headache, tiredness, and nausea and/or vomiting. [study.com]

  […] head injury may include: mild head injury raised, swollen area from a bump or a bruise small, superficial (shallow) cut in the scalp headache sensitivity to noise and light irritability confusion lightheadedness and/or dizziness problems with balance nausea [beaumont.edu]

• Hypertension

  Intracranial hypertension is typically associated with acute subdural hematoma and require is aggressive intervention to reduce ICP, and manage cerebral edema and swelling. [pharmacology2000.com]

  In the first day, the ICP was 12 mmHg, but lactate-pyruvate ratio was raised (35.7), which indicated early ischemia/intracranial hypertension. [scielo.br]

  The increase in endogenous catecholamines (sympathetic induced catecholamines release) causes vasoconstriction of peripheral vessels, which increases systemic arterial pressure (neurogenic hypertension) after traumatic brain injury (TBI). [minclinic.ru]

  It is caused by a combination of systemic hypotension and intracranial hypertension, leading to cerebral hypoperfusion. Cardiovascular collapse and other systemic changes may result from the effects of DAI on the medulla. [neuropathology-web.org]

• Contusion

  Administration of FVII prevented the progression of hemorrhaging from cerebral contusions by protecting microvessel endothelial cells in the penumbra of the contusion. [ncbi.nlm.nih.gov]

  Brain contusion, defined as superficial bruising of the brain, is one of the most common forms of traumatic brain injury (TBI). [symptoma.com]

• Fracture

  NYR injury news: McDonagh fracture, right foot, Gm 4. [blueshirtbanter.com]

  Presence of frontal sinus fracture was considered an indicator of high-impact trauma. Grading of brain contusion severity was performed using head CT scans. [ncbi.nlm.nih.gov]

  #NYR Injuries: McDonagh fracture-right foot gm 4. Girardi Grade 1 MCL sprain gm 4. [sportsnet.ca]

  Again, whether your injury is an epidural hematoma, concussion, blowout fracture, occipital fracture, brain swell, cerebral edema, subdural hematoma or any eye injury including an eye orbital fracture call us for a free consultation. [braininjury.1800nynylaw.com]

  What is a skull fracture? A skull fracture is a break in the skull bone. There are four major types of skull fractures, including the following: Linear Skull Fractures This type accounts for almost 70 percent of skull fractures. [beaumont.edu]

• Muscle Weakness

  The effects of this abuse are worse in infants because their heads are large and their neck muscles weak. Acceleration and deceleration of the brain causes severe traumatic brain injury and may also cause cervical spine injury. [neuropathology-web.org]

• Seizure

  Those who have sustained significant bruising may develop seizures, impaired cognition, or nerve damage that results in temporary or permanent paralysis. [wisegeek.com]

  Leading causes were headache followed by seizure and dizziness. Rehospitalization was increased in the patients with altered level of consciousness. [ncbi.nlm.nih.gov]

  Physical complications Seizures. Some people with traumatic brain injury will develop seizures. The seizures may occur only in the early stages, or years after the injury. Recurrent seizures are called post-traumatic epilepsy. [mayoclinic.org]

  She said Hayden was medically sedated Tuesday after having seizures. He has a skull fracture and a brain contusion, but no other injuries. [thecabin.net]

• Irritability

  The symptoms of a mild head injury may include: mild head injury raised, swollen area from a bump or a bruise small, superficial (shallow) cut in the scalp headache sensitivity to noise and light irritability confusion lightheadedness and/or dizziness [beaumont.edu]

  The symptoms of cerebral contusion can vary from non-specific symptoms such as nausea, vomiting, fits and irritability to becoming confused and unconscious. [leedsneurosurgery.com]

  Because emotions are also produced by interactions among brain cells, the concussed patient might show tearfulness, irritability or other changes in behavior as a result of the injury. [cordingleyneurology.com]

• Stroke

  Abstract Recent studies have demonstrated that peroxisome proliferator-activated receptor-alpha (PPAR-alpha) agonists can protect the brain against excessive oxidative stress and inflammation in traumatic brain injury (TBI) and stroke through endogenous [ncbi.nlm.nih.gov]

  Cerebral Infarction/Stroke When a blood clot blocks the blood flow to the brain, a person has an ischemic stroke. This type of stroke is also called a cerebral infarction or brain attack. [finr.net]

  The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. [uclahealth.org]

• Amnesia

  We include athletes who have lost consciousness for more than five minutes or experienced amnesia for more than 24 hours in the Grade 5 category. [brighamhealthhub.org]

  This is the period of posttraumatic amnesia. The longer the duration of amnesia, the more severe the brain damage. [msktc.org]

  Other signs of mild trauma may include impaired sensory perception, temporary confusion or amnesia, and personality changes. [wisegeek.com]

  Examples of symptoms include: Mild headache Poor balance or trouble standing Confusion Nausea Dizziness Small cut or bump Ringing in the ear Mild blurring of the vision Temporary amnesia People who experience any of these symptoms after a mild knock or [news-medical.net]

  The patient began to follow commands at day 5, but he remained in posttraumatic amnesia for several weeks. Memory dysfunction and deficits in executive control persisted throughout the acute rehabilitation period. [journals.lww.com]

• Personality Change

  Other signs of mild trauma may include impaired sensory perception, temporary confusion or amnesia, and personality changes. [wisegeek.com]

  S EQUELA Possible sequelae are divided into categories : physical problems emotional and personality changes motoric disorders psycho - social problems cognition (see list below for cognitive impairment ) After a TBI, neurons (nerve cells) in the brain [braininjury-explanation.com]

  Patients with serious closed head injuries may suffer from: Seizures Nerve damage Cognitive disabilities Communication difficulties Personality changes Changes in sensory perception Post-concussion syndrome Coma Most patients suffering from mild closed [allabouttbi.com]

  Cognitive deficits and personality changes may persist. [ncbi.nlm.nih.gov]

A thorough diagnostic workup of all head traumas is absolutely necessary, starting with a detailed patient history that will identify the type, severity and exact site of injury. As patients can often present with altered consciousness, it is advised to obtain data from friends or family members, after which a thorough clinical examination is necessary. In all patients with suspected TBI, the GCS score must be calculated, composed of three components - verbal response, eye-opening, and motor function [3] [5]:

• Best verbal response - Patients may be oriented (5), confused (4), speak incomprehensible words (3), mumble (2) or do not have a response of any kind (1).
• Eye opening can occur spontaneously (4), only to speech (3) or pain (2), while most severe injuries cause a complete loss of this function (1).
• Obeying of commands ordered by the physician (6), a localized purposeful response after pain stimulation (5), withdrawal after pain stimuli, abnormal flexion (3) or extension (2) after pain or no response at all (1) are motor response categories of the GCS.

The importance of GCS lies in the assessment of further diagnostic steps and the prognosis, as patients with a lower GCS score (moderate TBI is scaled from 9-13, while severe TBI is assumed when GCS scores are 3-8) are at a much great risk for clinical deterioration and the development of complications. For this reason, immediate employment of imaging studies is vital [2] [4] [5]. Noncontrast computed tomography (CT) is recommended as first-line, as it is able to identify signs of hemorrhage in all parts of the brain, whereas magnetic resonance imaging (MRI), although limited in the acute setting because of its inability to recognize hemorrhagic lesions in the first several hours after trauma, is recommended for more complex injuries that require additional workup [2] [4] [5].

Our human data largely parallel experimental findings in rats, indicating that such trauma models are relevant for experimental studies and treatment trials. [ncbi.nlm.nih.gov]

Treatment For Cerebral Contusion In cases of minor brain contusion, no specific treatment is required and these contusions tend to heal spontaneously. [tandurust.com]

Treatment for Brain Contusion It is essential to make quick diagnosis of brain contusion. Furthermore, it is essential to identify the underlying cause. [ic.steadyhealth.com]

RESULTS: The favorable prognosis rate in Group I, II and III was higher than Group IV on 6-month follow-up Glasgow Outcome Score (GOS). [ncbi.nlm.nih.gov]

A high score indicates a good prognosis and a low score indicates a poor prognosis. [neurosurgeonsofnewjersey.com]

Contusion alone did not worsen the prognosis of patients in short term follow up and did not cause neurosurgical interventions. Read more about Effects of brain contusion on mild traumatic brain injured patients [noninvasiveicp.com]

The importance of GCS lies in the assessment of further diagnostic steps and the prognosis, as patients with a lower GCS score (moderate TBI is scaled from 9-13, while severe TBI is assumed when GCS scores are 3-8) are at a much great risk for clinical [symptoma.com]

Etiology The etiology of cerebral contusion is trauma to the head. Most of the time, it is a closed head injury, but open injuries can also produce them. [ncbi.nlm.nih.gov]

Etiology SDH is usually the result of shear and of the tearing of a bridging vein. [slideplayer.fr]

Cerebral Contusion Epidemiology~Causes ~Direct hit to the head. ~Acceleration-deceleration injury. [quizlet.com]

The epidemiology of traumatic brain injury. J Head Trauma Rehabil. 2010 Mar-Apr;25(2):72-80. [PubMed: 20234226] 2. [ncbi.nlm.nih.gov]

Epidemiology & demographics Incidence: SDH is a common finding, especially among trauma patients. [slideplayer.fr]

It is concluded that TBI could greatly upregulate the binding activity and protein expression of PPAR-alpha in injured human brain, which might be important in brain pathophysiology after TBI. [ncbi.nlm.nih.gov]

The pathophysiological mechanisms following traumatic brain injury. Rev Assoc Med Bras 2009;55:75-81. [ Links ] 2. Ståhl N, Nordström CH. Brain energy metabolism during controlled reduction of cerebral perfusion pressure in severe head injuries. [scielo.br]

[…] contra-coup injury) if resulting from acceleration/deceleration type injury ~May occur with other intracranial injuries such as skull fractures, subdural or epidural bleeding ~Size can vary from millimeters to several centimeters Cerebral Contusion Pathophysiology [quizlet.com]

Consciousness Alteration of Consciousness Posttraumatic amnesia (PTA) Glasgow Coma Scale (GCS) Mild Normal 0–30 min ( Moment 13–15 Moderate Normal or Abnormal >30 min but >24 hours 1–7 days 9–12 Severe Normal or Abnormal >24 hrs >24 hours >7 days 3–8 Pathophysiological [minclinic.ru]

Administration of FVII prevented the progression of hemorrhaging from cerebral contusions by protecting microvessel endothelial cells in the penumbra of the contusion. [ncbi.nlm.nih.gov]

Supplementary oxygen is essential to prevent hypercapnia, due to suppressed breathing. Intensive care monitoring of patients with cerebral contusion is essential to prevent onset of grave complications. [tandurust.com]

Twitter Channel Facebook Profile Pinterest Profile Diseases and Conditions Prevention and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food and Nutrition [familydoctor.org]

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated March 6, 2014. [wnyurology.com]

Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. [biau.org]

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2. Kim JJ, Gean AD. Imaging for the Diagnosis and Management of Traumatic Brain Injury. Neurotherapeutics. 2011;8(1):39-53.
3. MCKee AC, Daneshwar DH. The neuropathology of traumatic brain injury. Handb Clin Neurol. 2015;127:45-66.
4. Lee B, Newberg A. Neuroimaging in Traumatic Brain Imaging. NeuroRx. 2005;2(2):372-383.
5. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
6. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.