Analysis of Geometric Relation between Cerebral Contusion and Site of Impact in Traumatic Brain Injury Patients

Abstract

Cerebral contusion is found in 17–34% of traumatic brain injury (TBI) cases. The inertial and contact effects responsible for this injury makes the presence and location of contusion almost impossible to detect without appropriate imaging techniques. This study aimed to identify the geometric association between site of impact and cerebral contusion in patients with TBI. Data were collected retrospectively from Dr. Hasan Sadikin Hospital Bandung, Indonesia from January 2016–December 2017. TBI patients were scanned for diagnosis of cerebral contusion on the initial CT scan and the presence of soft tissue swelling as the site of impact. The locations were then geometrically classified into four groups; frontal, right temporoparietal, left temporoparietal, and occipital. Analysis was then performed using the multinomial logistic regression method with α=0.05 and 95% confidence interval (CI). Right temporoparietal contusion was associated with contrecoup impact compared to frontal impact (p=0.008, OR 6.8, 95% CI: 1.6–28.7) and occipital impact (p=0.002, OR 6.8, 95% CI: 1.7–26.8) while left temporoparietal contusion was associated with contrecoup impact compared to frontal (p=0.006, OR 6.8, 95% CI: 1.7–26.8) and occipital impact (p=0.016, OR 10, 95% CI: 1.3-17) and with coup impacts compared to frontal impacts (p=0.025, OR 5.3, 95% CI: 1.2–23.3). It is concluded that temporal contusion has a statistically significant correlation with contrecoup impacts.

Keywords

• cerebral contusion, computed tomography, impact injury, traumatic brain injury