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Traumatic Intracerebral Contusions
Book chapter

Traumatic Intracerebral Contusions

Ilyas Eli, Mitchell Couldwell and Craig H. Rabb
Neurotrauma
Neurosurgery by Example, Oxford University Press
11/01/2019

Abstract

Cerebral contusions are a subtype of traumatic brain injury that classically result from coup or contrecoup injuries. Common locations for these injuries are the inferior frontal, temporal, and occipital lobes. Mass effect from edema and hemorrhagic progression are frequent with contusions. Depending on the clinical examination results and radiographic findings, treatment may be nonsurgical or surgical. A Glasgow Coma Scale (GCS) score of 8 or less warrants placement of an intracranial pressure (ICP) monitoring device. Surgery is indicated in patients with deterioration of neurological examination findings, ICP that is refractory to exhaustive medical management, or imaging findings of severe mass effect. Patients with moderate or severe traumatic brain injury (GCS <13) are typically admitted to intensive care units for close monitoring of neurological examination changes, hyponatremia, hemorrhagic progression, and postsurgical complications. Recovery varies widely, and outcomes depend on age, initial GCS score, size, and location of the contusion.

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