Cerebral Contusion - Causes, Symptoms and Treatment

Cerebral Contusion is a bruise of the brain tissue. Like bruises in other tissues, cerebral contusion can be caused by multiple microhemorrhages, small blood vessel leaks into brain tissue. A cerebral contusion can occur directly beneath the site of impact (coup) when the brain rebounds against the skull from the force of a blow (a beating with a blunt instrument, for example), when the force of the blow drives the brain against the opposite side of the skull, or when the head is hurled forward and stopped abruptly. The signs and symptoms of a contusion include severe headache, dizziness, vomiting, increased size of one pupil or sudden weakness in an arm or leg. The person may seem restless, aggitated or irritable. A contusion can happen to anyone, at any time. The most common causes of contusion include a blow to the head from a motor vehicle crash, fall or assault. People at higher risk are those who have difficulty walking and fall often, those who are active in high impact contact sports and people who are taking blood thinners, such as coumadin.

Contusions typically form in a wedge-shape with the widest part in the outermost part of the brain. Contrecoup injuries usually result in edema (swelling).  If the bleeding is extensive the contusion will lead to hematoma (a collection of blood).  Both edema and hematoma can lead to permanent brain damage or death. Hemorrhages may be larger than in normal contusions if the injury is quite severe. This type of injury has a poor prognosis if the patient is comatose, even with no apparent causes for the coma. Immediate treatment may include establishing a patent airway and, if necessary, tracheotomy or endotracheal intubation. If necessary, additional treatments may include blood transfusion and craniotomy to control bleeding and aspirate blood.

Causes of Cerebral Contusion

The common causes of Cerebral Contusion:

• Acceleration­deceleration or coup-contrecoup injuries.
• Damage to a major blood vessel within the head.

Symptoms of Cerebral Contusion

Some sign and symptoms related to Cerebral Contusion are as follows:

• Headache and dizziness.
• Vomiting.
• Increased size of one pupil or sudden weakness in an arm or leg.
• Memory loss.
• Nausea, vomiting.
• Slurred speech.
• Change in personality.

Treatment of Cerebral Contusion

• Immediate treatment may include establishing a patent airway and, if necessary, tracheotomy or endotracheal intubation.
• The patient's ICP may be reduced by maintaining his partial pressure of arterial carbon dioxide between 30 and 35 mm Hg.
• If necessary, additional treatments may include blood transfusion and craniotomy to control bleeding and aspirate blood.