Cerebral Contusion - Features

Features

Contusions, which are frequently associated with edema, are especially likely to cause increases in intracranial pressure (ICP) and concomitant crushing of delicate brain tissue.

Contusions typically form in a wedge-shape with the widest part in the outermost part of the brain.

The distinction between contusion and intracerebral hemorrhage is blurry because both involve bleeding within the brain tissue; however, an arbitrary cutoff exists that the injury is a contusion if two thirds or less of the tissue involved is blood and a hemorrhage otherwise.

The contusion may cause swelling of the surrounding brain tissue, which may be irritated by toxins released in the contusion. The swelling is worst at around four to six days after the injury.

Extensive contusion associated with subdural hematoma is called burst lobe. Cases of a burst frontal or temporal lobe are associated with high mortality and morbidity.

Old or remote contusions are associated with resorption of the injured tissue, resulting in various degrees of cavitation, in addition to the presence of a golden-yellow discoloration due to residual hemosiderin. These remote contusions are often referred to as plaque jaune or yellow plaque.

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