Traumatic brain contusions

Abstract

Traumatic brain injury is one of the most important causes of morbidity and mortality worldwide. One of its presentations includes traumatic brain contusions. Brain contusions are cortical lesions of necrotic tissue and multiple petechial haemorrhages, initially perivascular, that predominantly affect the crests of the convolutions, but that can extend through the cortex and reach the subcortical white matter. These result from a collision of the brain with the adjacent inner table of the skull, without proper treatment these can evolve and cause a rapid deterioration of clinical and neurological status. The classification includes mild, moderate, and severe TBI depending on the nature of the injury and the impact on the patient's clinical status. For the initial evaluation, computed tomography is usually used, although the magnetic resonance has greater sensitivity for the detection in these patients. Treatment is guided at preventing the progression of the lesion or the development of a secondary lesion, avoiding hypotension and hypoxia and maintaining adequate cerebral perfusion. Surgery is frequently needed in severe cases to remove intracranial hematomas, provide space for the brain to swell, or place monitors to track intracranial pressure and brain oxygenation. The aim of this article is to review the most important aspects to know about brain contusion.

Keywords

• brain contusion
• trauma
• emergency treatment
• neurotrauma
• central nervous system diseases
• narrative review